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Physician Archive

New York State Medicaid Prior Approval Requirements for Lung Cancer Screening (2/26/26, 129KB)
A New Provider Communication is Available (2/24/26, 221KB)
Updated Fee Schedule (1/26/26, 176KB)
Updated Fee Schedule (1/2/26, 173KB)
Two New Provider Communications are Available (12/22/25, 177KB)
A New Provider Communication is Available (12/12/25, 194KB)
Updated Fee Schedule (12/1/25, 193KB)
A New Provider Communication is Available (11/25/25, 189KB)
A New Provider Communication is Available (11/4/25, 139KB)
Updated Fee Schedule (10/27/25, 187KB)
Updated Fee Schedule (10/22/25, 179KB)
New York State Medicaid Coverage of the COVID-19 Vaccine for Children Under 19 Years of Age (10/17/25, 99KB)
Updated Fee Schedules (10/2/25, 170KB)
New York State Medicaid Coverage for COVID-19 Vaccinations Administered by Providers (9/22/25, 191KB)
A New Provider Communication is Available (7/16/25, 176KB)
A New Provider Communication is Available (7/11/25, 159KB)
Updated Fee Schedules (7/2/25, 177KB)
Electronic Submission of Claims (6/30/25, 133KB)
Notification of Pregnancy to Medicaid Managed Care Plans (5/22/25, 177KB)
Timely Postpartum Visit Incentive (4/18/25, 140KB)
Updated Provider Manuals (4/2/25, 147KB)
Notice for Upcoming Over-The-Counter Coverage Changes (3/25/25, 179KB)
SMS and Voice Call MFA Options on PE Maintenance Portal Will be Discontinued (3/20/25, 136KB)
Outreach to CDPAP Consumers and Caregivers Ahead of April 1 Transition to Statewide FI (3/10/25, 141KB)
Updated PAXpress User Guide (2/28/25, 158KB)
Updated Provider Manual (2/26/25, 166KB)
Updated Fee Schedule (1/7/25, 169KB)
New Provider Communications are Available (10/23/24, 122KB)
Updated Provider Manuals (10/8/24, 109KB)
A New Provider Communication is Available (9/30/24, 134KB)
Updated Provider Manual (9/26/24, 92KB)
Updated Fee Schedule (8/5/24, 83KB)
Updated Provider Manuals (7/16/24, 212KB)
Updated Fee Schedule (4/8/24, 291KB)
Updated Provider Manuals (3/29/24, 147KB)
A New Provider Communication is Available (3/12/24, 144KB)
Updated Fee Schedule (2/15/24, 321KB)
Updated Fee Schedule (2/7/24, 275KB)
2024 NYS Medicaid Dental Policy and Procedure Code Manual and Updated Fee Schedule (1/31/24, 331KB)
Updated Fee Schedule (1/12/24, 190KB)
Syphilis Screening During Pregnancy - A Call for Frequently Asked Questions (FAQs) (1/10/24, 140KB)
Updated Fee Schedule (1/3/24, 149KB)
Changes for Webinar for New NYS Medicaid Dental Policies (12/26/23, 183KB)
Updated Fee Schedule (12/15/23, 211KB)
A New Provider Communication is Available (12/4/23, 368KB)
New Webinar on NYS New Medicaid Dental Policies (12/4/23, 145KB)
A New Provider Communication is Available (11/17/23, 230KB)
A New Provider Communication is Available (11/8/23, 147KB)
Clarification to Durable Medical Equipment, Orthotics, Prosthetics and Supplies (DMEPOS) Fiscal Order Acceptance Policy (10/26/23, 150KB)
Information for Prescribing and Dispensing Providers of Enteral Products for Medicaid Members (10/23/23, 123KB)
A New Provider Communication is Available (10/10/23, 242KB)
Updated Continuous Glucose Monitoring Criteria (10/3/23, 148KB)
Updated Fee Schedule (10/2/23, 142KB)
Updated Fee Schedule (9/22/23, 277KB)
Updated Fee Schedule (9/1/23, 233KB)
A New Provider Communication is Available (8/23/23, 184KB)
Updated Fee Schedule (7/31/23, 188KB)
Updated Provider Manual (7/17/23, 143KB)
Updated Fee Schedule (7/5/23, 143KB)
Updated Fee Schedules (5/18/23, 192KB)
Updated Fee Schedules (5/15/23, 147KB)
Updated Fee Schedules (5/2/23, 148KB)
A DMEPOS Provider Communication is Now Available (5/2/23, 321KB)
A New Provider Communication is Available (4/21/23, 173KB)
Enteral Policy/Enteral Web Portal Training Webinar (4/19/23, 196KB)
NYRx, The Medicaid Pharmacy Program - Claims Submitted 4/1 - 4/4/2023 (4/5/2023, 143KB)
Two (2) NEW Provider Communications have been Posted (3/31/2023, 147KB)
ATTENTION: The Medicaid Enteral Web Portal Has Gone Live as of 3/2/23 (3/7/23, 168KB)
Attention: NYS Medicaid Enteral Prior Authorization Enhancements - Web Portal Launch and Training Sessions (2/16/23, 203KB)
Physcician Fee Schedule Updated (2/13/23, 244KB)
Physician Fee Schedules Updated (1/30/23, 161KB)
Physcician Fee Schedule Updated (1/24/23, 162KB)
Physcician Fee Schedules Updated (1/4/23, 165KB)
Physician Fee Schedule Updated (11/29/22, 172KB)
Physician Fee Schedule Updated (11/7/22, 130KB)
Physician Fee Schedule Updated (10/20/22, 130KB)
Physician Fee Schedules Updated (10/6/22, 150KB)
Physician Fee Schedules Updated (9/8/22, 150KB)
Physician Fee Schedules Updated (8/16/22, 149KB)
Physician Fee Schedule Updated (8/10/22, 149KB)
Physician Fee Schedule Updated (8/3/22, 149KB)
Physician Procedure Codes and Fee Schedules Updated (6/30/22, 151KB)
Physician Fee Schedule Updated (3/15/22, 150KB)
Dental Fee Schedule and Policy and Procedures Codes Manual have been updated (2/18/22, 146KB)
Physician Procedure Code Manual (Medicine and Drugs) Updated (11/22/21, 237KB)
Physician Fee Schedule Updated (10/1/21, 241KB)
Physician Procedure Code Manual and Fee Schedule (Surgery) Updated (9/24/21, 238KB)
Physician Fee Schedules Updated (9/8/21, 242KB)
Physician Fee Schedule Updated (8/27/21, 241KB)
Physician Fee Schedules Updated (8/3/21, 242KB)
The Issue That Caused Some Claims for Services Ordered by Nurse Practitioners to Incorrectly Deny has been Resolved (7/12/21, 251KB)
Physician Procedure Codes and Fee Schedules Updated (7/2/21, 244KB)
Physician Procedure Code Manual (Surgery) Updated (6/10/21, 237KB)
Physician Procedure Codes and Fee Schedules Updated (4/29/21, 239KB)
IVR Enteral PA Webinar has been posted (4/22/21, 240KB)
Webinars for the Interactive Voice Response System (IVR) for Medicaid Fee for Service (FFS) Enteral Product Authorizations (3/24/21, 260KB)
A New Physician Provider Communication is Available (3/16/21, 240KB)
Radiology Consult^TM Procedure Code List Updated (1/19/21, 237KB)
Physician Fee Schedules Updated (1/8/21, 241KB)
Physician Fee Schedules Updated (1/5/21, 242KB)
Physician Procedure Codes and Fee Schedules Updated (9/8/20, 236KB)
Webinars for Private Duty Nursing (PDN) New PDN Directory and Updates to Fee Schedule (9/2/20, 267KB)
Physician: Anesthesia, Surgery, Radiology, Medicine & Drugs, Procedure Codes and Fee Schedules Updated (8/18/20, 240KB)
Physician (Drugs) Fee Schedule Updated (6/8/20, 236KB)
Provider Communication for Automatic Blood Pressure Monitors (6/3/20, 236KB)
Provider Communication Response to COVID-19 Telehealth PCMH Payment (5/22/20, 260KB)
Physician (Medicine) Fee Schedule Updated (5/20/20, 237KB)
Radiology Consult^TM Procedure Code List Updated (5/6/20, 240KB)
Physician (Medicine) Fee Schedule Updated (4/14/20, 237KB)
Physician (Medicine, Surgery, Radiology, Drugs, Anesthesia) Fee Schedule Updated (4/30/20, 242KB)
Physician (Medicine) Fee Schedule Updated (4/14/20, 237KB)
National Diabetes Prevention Program Medicaid Enrollment Webinar is now Available (2/7/20, 148KB)
National Diabetes Prevention Program has been Updated (2/5/20, 138KB)
Physician Drug, Medicine, Radiology and Surgery Fee Schedules Updated (1/14/20, 132KB)
Private Duty Nursing Webinar by the Bureau of Medical Review Register Now (10/30/19, 243KB)
Revised Private Duty Nursing (PDN) Manual Now Available (10/25/19, 229KB)
Physician Surgery Fee Schedule Updated (8/30/19, 187KB)
Physician Surgery, Radiology and Drug Procedure Codes and Fee Schedules Updated (3/22/19, 154KB)
A New Provider Communication is Available (2/21/19, 158KB)
Updated Dental Provider Manuals and New Provider Communications are Available (2/12/19, 140KB)
Physician Anesthesia, Drug, Medicine, Radiology and Surgery Fee Schedules Updated (12/27/18, 154KB)
Attention: Updated Versions of the Dental Policy and Procedure Code Manual and Fee Schedule are Available (11/21/18, 110KB)
A New Physician Provider Communication is Available (11/5/18, 154KB)
Medicaid Fee-for-Service Providers Dispense Brand Name Drug when Less Expensive than Generic Program (10/26/18, 168KB)
New Edit to Validate Submitted Procedure Codes and Associated National Drug Codes (NDC's) (9/18/18, 161KB)
Update: New York State Medicaid Program Dental Policy and Procedure Code Manual (9/11/18, 171KB)
UPDATE: New HCPCS Code to be Used When Billing for Axicabtagene Ciloleucel (brand name YESCARTA^TM) (4/24/18, 171KB)
Physician Medicine and Drug Procedure Codes and Fee Schedule Updated (3/30/18, 153KB)
Physician Anesthesia, Radiology and Surgery Procedures Codes Updated (3/28/18, 153KB)
Important Enteral Prior Approval and Claim Requirement Change (3/9/18, 159KB)
Physician Anesthesia, Drug, Medicine, Radiology and Surgery Fee Schedules Updated (12/27/17, 158KB)
A New Provider Communication is Available (12/22/17, 158KB)
A New Provider Communication is Available (11/8/17, 177KB)
A New Provider Communication is Available (10/27/17, 155KB)
ATTENTION: Topical Oxygen Wound Therapy (TOWT) Continues to be Covered Until Further Notice (6/26/17, 178KB)
Radiology Prior Approval FAQ has been Updated (5/12/17, 155KB)
Physician Fee Schedules and Procedures Codes Updated (3/23/17, 177KB)
A New Provider Communication is Available (3/7/17, 188KB)
Physician Anesthesia, Drug, Medicine, Radiology and Surgery Fee Schedules Updated (12/29/16, 176KB)
A New Physician Provider Communication is now available. (12/28/16, 177KB)
HealthHelp Customer Experience Survey (12/13/16, 177KB)
A Physician Provider Communication is Now Available (9/6/16, 177KB)
Radiology Consult Procedure Code List Updated (5/4/16, 177KB)
Procedure Codes Now Requiring Prior Approval (2/12/16, 176KB)
Attention: Revised Reimbursement Methodology for Medicare/Medicaid Dually Eligible Clients (2/9/16, 178KB)
Attention: Providers of Reproductive Health Services (2/1/16, 204KB)
Physician Fee Schedules Updated (12/31/15, 76KB)
A Physician Provider Communication is Now Available (12/29/15, 76KB)
A Physician Provider Communication is Now Available (12/24/15, 75KB)
Threshold Override Applications (TOA) Require ICD10 Diagnosis Codes (10/14/15, 76KB)
A Physician Provider Communication is Now Available (10/2/15, 74KB)
A Physician Provider Communication is Now Available (9/30/15, 76KB)
Notification to Ordering and Billing Providers of Enteral Formula Products (9/29/15, 77KB)
A New Provider Communication is Now Available (9/23/15, 76KB)
Attention: Nurse Practitioner Collaboration Requirements NYS Medicaid eMedNY System Changes Being Made (8/27/15, 79KB)
OPRA Prescription Requirements for Unlicensed Residents, Interns and Foreign Physicians in Training (6/17/15, 90KB)
ATTENTION: Provider Enrollment Form Change (6/15/15, 159KB)
A Physician Provider Communication is Now Available (6/3/15, 76KB)
Important Information Regarding ICD-10 Implementation on October 1, 2015 (5/21/15, 86KB)
2015 Physician Procedure Codes Section and Fee Schedule Has Been Updated (5/6/15, 76KB)
Clarification on Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Post-Partum Service (4/9/15, 86KB)
Reminder: Reporting of the National Drug Code (NDC) is required for all Physician Administered Drugs for Medicaid Managed Care Plans (3/30/15, 77KB)
Physician Fee Schedules Updated (3/11/15, 76KB)
A Provider Communication for Physician Providers is Now Available (2/6/15, 159KB)
Physician Fee Schedules and Procedure Codes Updated (12/31/14, 159KB)
A Provider Communication for Physician Providers is Now Available (12/22/14, 159KB)
Claims Submitted with Add-on codes without Primary Procedure may Deny (12/19/14, 79KB)
Fee-for-Service Provider Enrollment for Physicians (10/17/14, 188KB)
NCCI Updated Edits Effective 10/1/2014 (10/7/14, 80KB)
Attention Prescribers: Final e-Prescriber Payments to be Issued By eMedNY (9/12/14, 188KB)
Attention Prescribers: Final e-Prescriber Payments to be Issued By eMedNY (8/26/14, 76KB)
Durable Medical Equipment Procedure Code and Fee Schedule Updates (7/21/14, 66KB)
2014 PCRI Fee Schedules Are Now Available (7/7/14, 66KB)
Ankle Foot Orthotics (AFOs) Allowed Frequency Update (6/12/14, 66KB)
Reimbursement for Long-Acting Reversible Contraception (LARC) Provided as an Inpatient Post-Partum Service (5/28/14, 76KB)
Edit 02166 - Delay Reason 11 (Other Delay) Invalid will pend Professional and Dental Paper Claims (4/29/14, 110KB)
Screening, Brief Intervention, and Referral to Treatment Webinar for Practitioners, Clinics and Emergency Departments (4/14/14, 77KB)
Electronic Prescribing Incentive Payments Discontinued Effective April 1, 2014 (4/9/14, 66KB)
Physician Procedures Codes & Fee Schedule Updated (4/4/14, 65KB)
2014 DME procedure codes section and fee schedule (3/28/14, 66KB)
Quarterly National Correct Coding Initiative (NCCI) Edits Updated (3/24/14, 71KB)
e-Prescriber Payments to be Issued By eMedNY (3/13/14, 67KB)
Web Training Scheduled To Guide Providers Especially Practitioners and Group Practices in Submitting Newly Required EFT and ERA or PDF Remittance Advice Requests Forms (2/12/14, 68KB)
Guidance To Group Practices For Correct Completion Of The Electronic Funds Transfer (EFT) Authorization Form (2/7/14, 74KB)
Updated Quarterly National Correct Coding Initiative (NCCI) Edits (1/15/14, 70KB)
ICD-10 Provider Readiness Assessment (1/15/14, 66KB)
Extension of the Medicaid Primary Care Rate Increase Attestation Deadline (1/14/14, 76KB)
Provider Training Schedule Available (1/8/14, 99KB)
Physician Fee Schedules Updated (1/2/14, 65KB)
Medicaid Prescription Footwear and Stocking Benefit Update (12/12/13, 72KB)
Attention Professional and Dental Providers: Claims Submitted With Delay Reason 2 - "Litigation" or Delay Reason 3 – "Authorization Delay" to Pend/Deny (12/5/13, 73KB)
Primary Care Rate Increase Retroactive Payments Now Available (12/03/2013, 64KB)
Web Training Scheduled To Guide Enrolled Practitioners and Group Practices in Submitting Newly Required EFT and ERA or PDF Remittance Advice Requests Forms (10/30/2013, 156KB)
NY Medicaid Guidance for Enrolled Practitioners Electronic Funds Transfer (EFT) and Electronic Remittance Advice (ERA) or PDF Remittance Advice (10/25/13, 263KB)
ATTENTION: Correction to the September 2013 Medicaid Update (10/17/13, 154KB)
Provider Training Schedule Available (10/07/13, 65KB)
Attention: Influenza Vaccine Coverage Expanded (09/23/13, 66KB)
Updated Primary Care Rate Increase Attestation FAQs Now Available (09/19/13, 173KB)
Attention All Providers: MRT 3 Initiatives to Begin (09/13/13, 54KB)
Enteral Nutritional Formula Webinar Power Point Presentation (07/29/13, 51KB)
Webinar: Enteral Nutritional Formula Regulation and Utilization Management Update (07/23/13, 52KB)
Enteral Formula Prior Authorization Phone System Update (07/18/13, 54KB)
Provider Training Schedule Available (07/16/13, 52KB)
Enteral Formula Telephone Authorization System Update (07/11/13, 52KB)
Medicaid Primary Care Rate Increase is Here! (07/11/13, 58KB)
Fee for Service Enteral Formula Prior Authorization (07/01/13, 58KB)
Incontinence Prescriber Communication ICD-9 Quantity Tool (06/28/13, 52KB)
Primary Care Rate Increase (PCRI) Fee Schedule is Now Available (06/20/13, 51KB)
Enteral Nutritional Formula Benefit Update (06/14/13, 61KB)
Information Regarding Primary Care Rate Increase (06/11/13, 51KB)
Webinar Invitation for Primary Care Rate Increase (05/29/13, 54KB)
Physician_Primary_Care_Rate_Increase_Attestation_Now_Available_05-02-13 (05/02/13, 54KB)
Edit 02166 'Delay Reason 11(Other Delay) Invalid' Will Deny Claims Beginning April 25, 2013 (04/25/13, 59KB)
Primacy Care Rate Increase (PCRI) Attestation Form Error (4/16/13, 60KB)
Updated Physician Fee Schedules and Procedure Codes are Now Available (4/09/13, 52KB)
Provider Training Schedule Available (04/05/13, 48KB)
Provider Training Schedule Available (03/6/13, 52KB )
Edit 02165 - Delay Reason 10 (Administration Delay in the Prior Approval Process) Invalid will deny claims beginning March 7, 2013 (3/05/13 58KB)
Additional Billing Information for Vaccine Administration Codes (1/15/13 52KB)
Updated Physician Fee Schedules Are Now Available (1/15/13 52KB)
Physician Medicine Fee Schedules Updated (1/10/13 51KB)
Physician Fee Schedules Updated (1/03/13, 51KB)
2013 Physician Procedure Code Changes Are Now Available (12/28/12, 65KB)
Changes in Medicaid Billing For Vaccine Administration (12/26/12, 51KB)
Prescriber Prevails in Medicaid Managed Care for Atypical Antipsychotics (12/24/12, 62KB)
Changes In Medicaid Billing For Vaccine Administration (12/11/12, 51KB)
New Family Planning Benefit Program Service Available November 1, 2012 (10/29/12, 52KB)
New Allergy Services and Anesthesiologist Provider Communications are Available (10/15/12, 51KB)
e-Prescriber Payments to be Issued By eMedNY (09/27/12, 52KB)
New Website Portal Available to Initiate Fee-for-Service Pharmacy Prior Authorization Requests (09/06/12, 62KB)
Important Reminder for All Ordering and Billing Providers of Incontinence Supplies (08/30/12, 52KB)
Attention Prescribers: e-Prescribing Payments To Be Issued by eMedNY (04/10/12, 53KB)
Improve Modifier Editing (02/22/12, 57KB)
DVS to be Required for Occupational, Physical, and Speech Therapy Effective 2/23/2012 (02/17/12, 54KB)
Prior Authorization Process Update for Out of State Skilled Nursing Facilities (01/25/12, 52KB)
Physician Medicine and Surgery Fee Schedules Updated (01/23/12, 37KB)
Physician Fee Schedules Updated (12/29/11, 38KB)
Procedure Code Changes Effective January 1, 2012 (12/27/11, 38KB)
Upcoming Changes to the Fee-for-Service Pharmacy Prior Authorization Process (12/15/11, 48KB)
EHR Incentive Program Announcement (10/26/11, 39KB)
Out of State Non-Specialized Skilled Nursing Facility Prior Authorization Has Been Updated (10/21/11, 40KB)
Attention Pharmacies and Prescribers: Eligibility Transaction Update (10/05/11, 38KB)
Attention: Changes to Prior Authorization for Out of State Skilled Nursing Facilities (09/26/11, 35KB)
Eliminating Payment for Inactive Procedure Codes for Physician Billing (09/09/11, 38KB)
Update to the Medicaid Drug Rebate Program (07/12/11, 38KB)
July 1, 2011 Radiology Fee Schedule Update (07/06/11, 38KB)
Physician Radiology Fee Schedule and Procedure Code List Updated (05/13/11, 36KB)
Enteral Formula Prior Authorization Prescriber Worksheet Revised (05/04/11, 38KB)
Enteral Nutritional Formula Benefit Update (04/19/11, 40KB)