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Provides up-to-date changes that may affect your participation in the Medicaid Program.
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Provider Manuals > Physician Manual
Procedure Codes & Fee Schedules
|Primary Care Rate Increase (PCRI) Fee Schedule||Last updated on 1/1/2014|
|Fee Schedules: Medicine||Last updated on 2/6/2023|
|Fee Schedules: Drugs||Last updated on 2/13/2023|
|Procedure Codes: Medicine and Drugs||Last updated on 6/30/2022|
|Fee Schedules: Radiology||Last updated on 1/24/2023|
|Procedure Codes: Radiology||Last updated on 6/30/2022|
|Fee Schedules: Surgery||Last updated on 12/22/2022|
|Procedure Codes: Surgery||Last updated on 4/19/2022|
|Enhanced Program Fee Schedule||Last updated on 12/22/2022|
|Fee Schedules: Anesthesia||Last updated on 4/19/2022|
|Procedure Codes: Anesthesia||Last updated on 4/19/2022|
Click here for the list of Medicaid Drug Rebate Program Participating Drug CompaniesThe list of participating drug companies provides a tool for practitioners to identify drug labelers/vendors that participate in the Medicaid Drug Rebate Program. Please note that the first 5 digits of the National Drug Code (NDC) represent the labeler/vendor. If the labeler code is not on this list, the labeler's drug is not reimbursable by Medicaid. Please refer to this list periodically, as the list of covered labelers/vendors is continually being updated. For billing and reimbursement of practitioner administered drugs, refer to your Provider Manual Procedure Code and Fee Schedule sections for Drugs, and Provider Communications, listed above.
Medicaid Pharmacy List of Reimbursable Drugs (Formulary File)As a reference tool for pharmacies and prescribers, the Formulary File contains prescription and over the counter drugs, as well as glucometer and home blood glucose test strip products, covered through the Pharmacy benefit. For billing and reimbursement of practitioner administered drugs, refer your Provider Manual Procedure Code and Fee Schedule sections for Drugs, and Provider Communications, listed above.