Author Topic: NYS Medicaid 2016 Fee Schedule?  (Read 893 times)

Christy

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NYS Medicaid 2016 Fee Schedule?
« on: January 10, 2017, 05:29:44 PM »
does anyone have a copy or link to the 2016 Medicaid Fee schedule?

I can only find 2017.

I am specifically looking for rates for BH codes:

90791
90837
90834
90847
90846
90853

I would be eternally grateful to anyone who could help.  :)

thank you

Michele

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Re: NYS Medicaid 2016 Fee Schedule?
« Reply #1 on: January 10, 2017, 08:37:56 PM »
I do not believe the fee schedule has changed so 2016 & 2017 are the same.  https://www.emedny.org/ProviderManuals/ClinicalPsych/PDFS/Clinical_Psychology_Fee_Schedule.pdf 
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Christy

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Re: NYS Medicaid 2016 Fee Schedule?
« Reply #2 on: January 11, 2017, 08:43:32 AM »
thank you!

now that one is different than this one (the one I found for 2017)

https://www.emedny.org/ProviderManuals/Physician/

if you go down to:

Procedure Codes & Fee Schedules

 Primary Care Rate Increase (PCRI) Fee Schedule   Last updated on 1/1/2014
 Fee Schedules: Medicine

that fee schedule opens into an excel file and the codes there show much higher rates.  any thoughts on that?



Michele

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Re: NYS Medicaid 2016 Fee Schedule?
« Reply #3 on: January 11, 2017, 08:58:12 AM »
Since the codes you listed were mental health I went to the provider manual for psychologists and got the fee schedule from there.  The one you are looking at is the physician's fee schedule.  I think it will depend on the credentials of the provider that you are billing for. 
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Christy

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Re: NYS Medicaid 2016 Fee Schedule?
« Reply #4 on: January 11, 2017, 09:04:33 AM »
ok, I thought maybe that was the case.  thank you!  yes, I am looking for LCSW which of course isn't covered by Medicaid.  I am in a fight with Beacon over the Beacon rates vs Medicaid rates.

Beacon was paying $60 for 90834 for years. Now they are threatening one of my LCSWs that they are going to recoup past payments down to the Medicaid rate.   >:(

thank you!
« Last Edit: January 11, 2017, 09:08:44 AM by Christy »

Michele

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Re: NYS Medicaid 2016 Fee Schedule?
« Reply #5 on: January 12, 2017, 07:09:28 AM »
Wow!  Is it for a Medicaid replacement plan?  We bill for several LCSWs that see Beacon Patients as well.  Seems unfair that they can go back but I've seen it before.  Keep us posted!
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Christy

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Re: NYS Medicaid 2016 Fee Schedule?
« Reply #6 on: January 26, 2017, 02:59:51 PM »
yes, Medicaid replacement plan and I believe Beacon is in error.