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What's New > Archives > 2008

Status Date Page/Document Description
New 12/31/08 Provider Manuals Update

New Provider Communications:

Changed 12/30/08 Provider Enrollment Forms

NYS Legislation has extended the Medically Fragile Program to December 2010. Please see new letter which precedes the form: (Note: the form remains unchanged.)

New 12/29/08 Provider Manuals Update

New Provider Communications:

Changed 12/29/08 Provider Manuals Update

An Update has been made to:

New 12/22/08 Provider Manuals Update

New Provider Communications:

New 12/22/08 Provider Manuals Update

New Provider Communications:

Changed 12/18/08 Provider Manuals Update

Modifications have been made to the following:

Changed 12/11/08 Provider Manuals Update

The following Fee Schedule is a replacement:

Changed 12/08/08 Provider Manuals Update

Modifications have been made to the listed billing guidelines as follows:
The line that contained the 8 digit MMIS Provider ID, NPI Number and Check Issue Date that appeared above the Provider Name in the address area on the paper check sample has been removed.

Changed 11/25/08 Provider Manuals Update

The following 2009 Fee Schedules and Procedure Codes sections have been updated:

New 11/21/08 Provider Enrollment Forms

New Provider Enrollment Packets:

Changed 11/06/08 Provider Manuals Update

Modifications have been made to the following:

New 11/06/08 Provider Manuals Update

New Provider Communications:

New 10/30/08 Provider Manuals Update

New Provider Communications:

Changed 10/27/08 Provider Manuals Update

Inquiry - Information for All Providers has been updated. Please note the change to the Enrollee Eligibility Determination telephone number. Please see:

Changed 10/27/08 Provider Manuals Update

Third Party - Information for All Providers has been updated. Please note the Code "FL: Pharmacare" has been deleted, as this is now associated with "DV: Caremark." Change the telephone number for Prepaid Capitation Plan "KX" to 212 563-5570. Update the Prepaid Capitation Plan listing with information from the Office of Managed Care dated 10/3/08. Please see:

Changed 10/23/08 Provider Manuals Update

MEDS II Data Element Dictionary updated for:

Changed 10/23/08 Provider Manuals Update

Modifications have been made to the following:

Changed 10/23/08 Provider Manuals Update

The following Policy Guidelines Manual has been updated:

New 10/20/08 Provider Manuals Update

New Provider Communications:

New 10/16/08 Provider Manuals Update

New Provider Communications:

New 10/09/08 Provider Manuals Update

New Provider Communications:

Changed 10/06/08 eMedNY Paper Forms

The following eMedNY Paper Forms documents have been updated with NPI information and address information:

Changed 10/02/08 Provider Manuals Update

Modifications have been made to the following:

Changed 10/02/08 Provider Manuals Update

Third Party - Information for All Providers has been updated. Please note the deleted code FL:Pharmcare because it was merged with DV: Caremark. Changed the telephone number for PCP code KX. Please see:

Changed 09/25/08 eMedNY Paper Forms

The following eMedNY Paper Forms and Instructions have been updated with NPI information:

New 09/22/08 Provider Manuals Update

New Provider Communications:

Changed 09/15/08 Provider Manuals Update

Modifications have been made to the following billing guide:

Changed 09/08/08 eMedNY Paper Forms

The following eMedNY Paper Forms have been updated with NPI information:

Changed 09/08/08 Provider Manuals Update

The following PA Guidelines Manual has been updated:

New 09/08/08 Provider Manuals Update

New Provider Communications:

Changed 09/04/08 Provider Manuals Update

Instructions for entering Present on Admission (POA) information was added to the following Billing Guide:

New 09/04/08 Provider Manuals Update

New Provider Communications:

Changed 09/04/08 Provider Manuals Update

Modifications have been made to the following billing guide:

Changed 08/28/08 Provider Manuals Update

Below are the Information for All Providers Manuals and the Transportation Manual Policy Guidelines with changes necessitated by NPI:

Changed 08/25/08 Provider Enrollment Forms

NPI updates were made to the Electronic Funds Transfer (EFT) Enrollment Form.

New 08/25/08 Provider Manuals Update

New Provider Communications:

Changed 08/21/08 Provider Enrollment Forms

Changes were made to accept Zip +4 for the following form:

Changed 08/21/08 Provider Manuals Update

NPI modifications have been made to the following:

New 08/18/08 Information

Under Notifications, please see two new Provider Letters regarding Family Health Plus Enrollees for billing requirements effective October 1st, 2008. These letters have been mailed to Pharmacy and Prescribing Providers.

Changed 08/18/08 Provider Manuals Update

Modifications have been made to the following:

New 08/07/08 Provider Manuals Update

New Provider Communications:

Changed 08/04/08 Provider Enrollment Forms

Changes were made to meet the requirements of 42 CFR, §455.105 to the following:

Changed 08/04/08 Provider Manuals Update

The following PA Guidelines have been updated:

Changed 08/04/08 Provider Manuals Update

The following PA Guideline has been updated:

Changed 07/24/08 Provider Enrollment Forms

Web PDF printing instructions were added and updates were made to the Electronic/Paper Transmitter Identification Number (TSN/Provider) and Electronic Transmitter Identification Number (TSN/Service Bureau) Provider Enrollment Forms Packets.

Changed 07/24/08 Provider Manuals Update

Modifications have been made to the following billing guides:

New 07/21/08 Provider Manuals Update

New Provider Communications:

New 07/11/08 Provider Manuals Update

New Provider Communications:

Changed 07/09/08 Provider Manuals Update

The policy on ambulance transportation to and from Regional Perinatal Centers (page 7) has been updated.  Regional perinatal centers are responsible for the costs of ambulance transportation to the center. Upon discharge, the cost of ambulance transportation is fee-for-service.

Changed 07/02/08 Provider Manuals Update

New Provider Communications:

Changed 07/02/08 Provider Manuals Update

The following grammatical changes were made: "recipient" was changed to "enrollee" and "Office of Medicaid Management" was replaced with "Office of Health Insurance Programs" for the following:

Changed 07/02/08 Provider Manuals Update

The following have been updated semantically to change references from MMIS Provider ID to Provider ID:

New 06/27/08 Provider Manuals Update

New Provider Communications:

Changed 06/25/08 Provider Manuals Update

The following Fee Schedule is a replacement:

Changed 06/20/08 Provider Manuals Update

Modifications have been made to the following billing guides:

Changed 06/18/08 Self Help

The Admission Type in the ePACES Institutional Claim Reference Guide, available in the Self Help section, was updated to indicate that Outpatient claims use this field to indicate an emergency service. Please see:

Changed 06/18/08 Provider Manuals Update

As this version of policy remains accurate, we are reposting the 2006 version of this manual:

Changed 06/13/08 Information for All Providers Update

The description of insurance code "WF" has been changed from "Fiserv" to "UMR" and "J8" has been changed from "Jardine Group Services" to "JLT Services Corp". Additionally, contact information for Prepaid Capitation Plan YR has been added to the following document:

Changed 06/13/08 Provider Manuals Update

Modifications have been made to the following billing guides:

Changed 06/13/08 Provider Manuals Update

The policy section of the transportation provider manual was updated to include information about the National Provider Identification (NPI) number. Additionally, information included in recent Medicaid Updates, particularly the change if the fees paid for using a toll bridge or tunnel in New York City, was placed in the manual. Please see:

Changed 06/06/08 Provider Manuals Update

Modifications have been made to the following:

New 06/06/08 Provider Manuals Update

New Provider Communications:

Changed 05/21/08 Provider Enrollment Forms

Changes were made to the Rate Based Change of Address Form.

Changed 05/21/08 Provider Manuals Update

The following Fee Schedules, Fee Schedule Column Descriptions, and Procedure Codes Sections (Section 1- General Information, Section 2 - Medicine, Section 3 - Drugs and Drug Administration, Section 4 - Radiology, and Section 5 - Surgery) have been updated effective 05/15/2008 for:

Changed 05/14/08 Provider Manuals Update

The Department is including information on our "Pay and Seek" policy. In the case of certain ambulatory pregnancy-related services, and primary care provided to children, Medicaid pursues a “pay and seek” method of reimbursement. This means that you should bill Medicaid for certain diagnosis codes without first pursuing any available third party insurance. This information can be found on page 18 of this updated policy section.

Changed 04/30/08 Provider Manuals Update

The following Fee Schedule and Procedure Codes sections have been updated effective 05/01/08.

Changed 04/23/08 Provider Manuals Update

Modifications have been made to the following:

Changed 04/18/08 Provider Manuals Update

Modifications have been made to the following:

Changed 04/16/08 Provider Manuals Update

The DME Manual has been changed. The previous policy section has been removed, as it contained misinformation. The current policy section in place reverts to the previous policy section. Please see:

Changed 04/11/08 Provider Manuals Update

The following Fee Schedules and Procedure Codes sections have been updated effective for dates of service 4/1/2008 and later:

Changed 04/04/08 Provider Manuals Update

The Home Health Manual has been updated. A section on the home assessment requirement for prior approval of private duty nursing services has been added on pages 5-6. Please see:

New 04/02/08 Provider Manuals Update

New Provider Communications:

Changed 03/28/08 Provider Manuals Update

Information For All Providers - Changes were made to include the PO boxes from the April 2008 Medicaid Update. Please see:

Changed 03/21/08 Provider Manuals Update

This section was changed, starting on page 10. The 'Plan Type' has been added to each managed care plan. For example, some plans are considered 'mainstream,' while others may be 'Family Health Plus.'

Changed 03/12/08 Self Help

Mailing addresses for the following FAQs have been updated:

New 03/07/08 Provider Manuals Update

New Provider Communications:

Changed 03/07/08 Provider Manuals Update

The policy section of the DME Provider Manual has been revised to include information sent to providers in different publications of the Medicaid Update during 2007. Please see :

Changed 03/07/08 Provider Manuals Update

The following Billing Guidelines Manual has been updated:

New 03/07/08 Provider Manuals

The following Policy Guidelines Manual has been added:

Changed 03/05/08 Provider Manuals Update

The following Prior Authorization Guidelines Manual has been updated:

Changed 02/29/08 Provider Enrollment Forms

P.O. boxes were added to addresses for the following:

 

New 02/20/08 Provider Manuals Update

The Following Prior Approval Guidelines Manual has been added:

Changed 02/15/08 Self Help Update

Added bullet to Service line section on page 20: To indicate the NDC, Drug Unit Price and National Drug Unit Count when billing physician administered drugs in the following document:

Added bullet to Service Line section on page 18: To indicate the NDC, Drug Unit Price and National Drug Unit Count when billing physician administered drugs in the following document:

Added sentence to More section on page 16: These claim types should use the MORE button in order to report the Deductible, Coinsurance, the Medicare Psychiatric Reduction amounts, NDC, Drug Unit Price and/or National Drug Unit Count. NDC information will be reported for Ordered Ambulatory Providers if they are submitting physician-administered drugs in the following document:

Changed 02/13/08 Provider Enrollment Forms Update

A check box was added (Item # 8) to allow the provider to revert back to paper prior approval determinations for the Electronic Prior Approval Request Form.

New 01/30/08 Provider Enrollment Forms

The following Provider Maintenance form has been added:

Changed 01/25/08 Provider Manuals Update

Contact Information has been changed in the following manuals:

Changed 01/23/08 Provider Manuals Update

Changes were made to the Care at Home Waiver Section on pages 9-10 of the Policy Guidelines. Please see:

Changed 01/23/08 Provider Manuals Update

Private Duty Nursing Procedure Codes and Fee Schedule update is available, effective for dates of service 1/1/2008 and later.

New 01/18/08 Provider Manuals Update

New Provider Communications:

Changed 01/11/08 Provider Manuals Update

Information For All Providers - Third Party Information has been updated to reflect changes to the Prepaid Capitation Plan codes and contact information. Additionally, a new Third Party Insurance code, 'TP' Prime Therapeutics Pharmacy has been added. Please see:

New 01/09/08 Provider Manuals Update

New Provider Communications:

Changed 01/04/08 Provider Manuals Update

The following Billing Guides and Provider Manuals have been updated

An address change was made to the Stop Loss Policy and Procedures and the Provider Manual for:

 

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