Durable Medical Equipment (DME) Update
(Oct. 19, 2020) Each year Kentucky Medicaid is required to provide an upper payment limit demonstration for CMS on DME codes covered by Kentucky Medicaid. This demonstration must reflect reimbursement rates for Kentucky Medicaid are set at or below the rates for the same codes listed by Medicare. Kentucky Medicaid was notified by CMS that it was out of compliance and must make adjustments to its fee schedule. To bring Kentucky Medicaid into compliance the Department for Medicaid Service immediately ordered a rate change adjustment to the 2020 DME fee schedule retroactive to Jan. 1, 2020. This triggered a recoupment for paid claims with codes haing rate decreases. This recoupment was in error. The recouped amounts will be reprocessed and repaid. Kentucky Medicaid apoligizes for the late notice and inconvenience. The new effective rate date is Nov. 15, 2020.
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Disclaimer: The appearance on this website of a code and rate is not an indication of coverage or a guarantee of payment.
To request older copies of fee schedules, please submit an open records request by mail or fax directly with the open records custodian at the address is below.
Open Records Custodian
Dept. for Medicaid Services
275 East Main Street, 6W-C
Frankfort, Kentucky 40601
(502) 564-8196 x2035 (P)
(502) 564-6917 (Fax)