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Material Incorporated by Reference

Be sure to view all document sections for all relevant regulations, manuals or incorporated materials. Some larger documents are divided into sections (Part A, Part B, etc.) to minimize download times. Click on one of the following 907 KAR Chapters to view the material listed below:

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907 KAR Chapter 1

907 KAR 1:008: Ambulatory Surgical Centers Material Incorporated by Reference:

907 KAR 1:018: Reimbursement for Drugs Material Incorporated by Reference:

907 KAR 1:019: Outpatient Pharmacy Program Material Incorporated by Reference:

907 KAR 1:022: Nursing Facility Services and Intermediate Care Facility for Individuals with Mental Retardation or a Developmental Disability Services Material Incorporated by Reference:

907 KAR 1:023: Review and Approval of Selected Therapies as Ancillary Services in Nursing Facilities Material Incorporated by Reference:

907 KAR 1:025: Payments for ICF/MR and Cost-Based Facilities Material Incorporated by Reference:

907 KAR 1:026: Dental Services Material Incorporated by Reference:

  • Map-9 - Prior Authorization for Health Services, December 1995 edition
  • Map-9A - Kentucky Medicaid Program Orthodontic Services Agreement, December 1995 edition
  • Map-306 - Temporomandibular Joint (TMJ) Assessment Form, December 1995 edition
  • Map-396 - Kentucky Medicaid Program Orthodontic Evaluation Form, March 2001 edition
  • Map-559 - Six (6) Month Orthodontic Progress Report, December 1995 edition
  • MAP-700 - Kentucky Medicaid Program Orthodontic Final Case Submission, December 1995 edition

907 KAR 1:030: Home Health Agency Services Material Incorporated by Reference:

907 KAR 1:031: Payments for Home Health Services Material Incorporated by Reference:

907 KAR 1:038: Hearing and Vision Program Services Material Incorporated by Reference:

907 KAR 1:044: Community Mental Health Center Services Material Incorporated by Reference:

907 KAR 1:045: Payments for Community Mental Health Center Services Material Incorporated by Reference:

907 KAR 1:055: Payment for Primary Care Center and Federally Qualified Health Center Services Material Incorporated by Reference:

  • MAP-100501 - Prospective Payment System Rate Adjustment, November 2001 edition
  • MAP - 100601 - Scope of Services Survey Baseline Documentation, November 2001 edition

907 KAR 1:065: Payments for Price-Based Nursing Facility Services Material Incorporated by Reference:

907 KAR 1:145: Supports for Community Living Services Material Incorporated by Reference:

907 KAR 1:155: Payments for Supports for Community Living Services Material Incorporated by Reference:

907 KAR 1:160: Home and Community Based (HCB) Waiver Program Material Incorporated by Reference:

907 KAR 1:170: Reimbursement for home and community based waiver services Material Incorporated by Reference:

907 KAR 1:270: Podiatry Program Services Material Incorporated by Reference:

907 KAR 1:320: Kentucky Patient Access and Care System (KenPAC) Material Incorporated by Reference:

907 KAR 1:340: Reimbursement for Hospice Services Material Incorporated by Reference:

  • MAP 374 - Election of Medicaid Hospice Benefit Form, September 2002 edition
  • MAP 384 - Hospice Drug Form, September 1992 edition

907 KAR 1:400: Renal Dialysis Center Services Material Incorporated by Reference:

907 KAR 1:418: Rural Health Clinic Services Material Incorporated by Reference:


907 KAR 1:427: Primary Care Services Material Incorporated by Reference:

907 KAR 1:434: Family Planning Services Material Incorporated by Reference:

907 KAR 1:436: Hospice Services Manual Material Incorporated by Reference:

907 KAR 1:450: Nurse Aide Training Criteria and Registry Material Incorporated by Reference:

907 KAR 1:479: Durable Medical Equipment Covered Benefits and Reimbursement Material Incorporated by Reference:

  • MAP-9 - Prior Authorization Form, July 2010 edition
  • MAP-1000 - Certificate of Medical Necessity, July 2010 edition
  • MAP-1000B - Certificate of Medical Necessity, Metabolic Formulas and Foods, July 2010 edition
  • Medicaid DME Program Fee Schedule, January 2010 edition
  • MAP 1001 - Advance Member Notice, September 2006 edition

907 KAR 1:550: Targeted Case Management Services for Adults Material Incorporated by Reference:

907 KAR 1:555: Targeted Case Management Services for Children Material Incorporated by Reference:

907 KAR 1:560: Medicaid Hearings and Appeals Regarding Eligibility Material Incorporated by Reference:

  • Form PAFS-78, May 1996 edition, Department of Medicaid Services

907 KAR 1:595: Model Waiver II services and payments Material Incorporated by Reference:

  • Map -9 - Prior Authorization for Health Services, December 1995 edition

907 KAR 1:600: Medicaid Adverse Action Conditions for Recipients Material Incorporated by Reference:

907 KAR 1:605: Medicaid Procedures for Determining Initial and Continuing Eligibility Material Incorporated by Reference:

907 KAR 1:610: Medicaid Rights to Apply and Re-apply Material Incorporated by Reference:

  • PA-1, revised October 1992
  • PA-1A, revised March 1991
  • PA-1C, revised October 1991
  • PA-1P, revised April 1992
  • PA-1UP, revised May 1991
  • KIM-100, revised March 1994

907 KAR 1:672: Provider Enrollment, Disclosure, and Documentation for Medicaid Participation Material Incorporated by Reference:

907 KAR 1:675: Program Integrity Material Incorporated by Reference:

  • Map-800 - Notice of Fraud and/or Abuse Committed Against The Medicaid Program, Department for Medicaid Services, 8/99 edition

907 KAR 1:677E: Medicaid Recipient Lock-in Program Material Incorporated by Reference:

907 KAR 1:705: Demonstration project: Services Provided Through Regional Managed Care Partnerships (1115) Waiver Material Incorporated by Reference:

907 KAR 1:710: Managed behavioral health care initiative (1915b Waiver) Material Incorporated by Reference:

907 KAR 1:755: Preadmission Screening and Resident Review Program (PASARR) Manual Material Incorporated by Reference:

  • The Manual, Long Term Care Resident Assessment Instrument User's Manual Version 2.0 for use with version 2.0 of the Health Care Financing Administration's Minimum Data Set, Resident - Part A - Part B - Part C - Part D - Part E

907 KAR 1:805: Breast and Cervical Cancer Eligibility for Medicaid Material Incorporated by Reference:

  • MAP-813B - BCCTP Eligibility Screening Form, September 9, 2002 edition
  • MAP-813 - Breast and Cervical Cancer Treatment Program Application, January 15, 2003 edition
  • MAP-813D - Breast and Cervical Cancer Treatment Program Request for Extension of Eligibility, January 15, 2003 edition

907 KAR 1:835: Michelle P. Waiver Services Material Incorporated by Reference:

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907 KAR Chapter 3

907 KAR 3:020: Targeted Case Management and Rehab through Title V Agency Material Incorporated by Reference:

907 KAR 3:090: Acquired Brain Injury Services Material Incorporated by Reference:

907 KAR 3:110: Community Mental Health Center Substance Abuse Services Material Incorporated by Reference:

907 KAR 3:210: Acquired Brain Injury Services Long Term Care Waiver and Reimbursement Material Incorporated by Reference:

907 KAR 3:215 - Tobacco Cessation Coverage and Reimbursement Material Incorporated by reference:

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907 KAR Chapter 5

907 KAR 5:005E - Health insurance premium payment (HIPP) program Material Incorporated by reference:

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907 KAR Chapter 10

907 KAR 10:012: Inpatient Hospital Service Coverage Material Incorporated by Reference:

907 KAR 10:015: Payments for Outpatient Hospital Services Material Incorporated by Reference:

907 KAR 10:372: Mental Hospital Services Material Incorporated by Reference:

907 KAR 10:376: Hospital Services Material Incorporated by Reference:

907 KAR 10:815: Non-Diagnostic Related Group Inpatient Hospital Reimbursement Material Incorporated by Reference:

907 KAR 10:820: Disproportionate Share Hospital Distributions Material Incorporated by Reference:

907 KAR 10:825: Diagnosis-related group (DRG) Inpatient Hospital Reimbursement Manual Material Incorporated by Reference:

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907 KAR Chapter 11

907 KAR 11:034: Early Periodic Screening and Diagnostic Testing (EPSDT) Screening Services and EPSDT Special Services Material Incorporated by Reference:

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Chapter 17

 
Last Updated 11/1/2011
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