Medicaid Billing Changes

Hello all, 

We are aware of changes from DHS that became effective on 9/19 regarding PAs ability to bill independently for Medicaid services. Since 7/1/24, PAs have been able to be the rendering/treating and billing provider on Medicaid claims through State Plan Amendment 24-0003 which also included other changes unrelated to PA billing. DHS received a request for additional information from CMS on 9/16 which halted the approval process for the Amendment to be enacted, therefore immediately halting claims for PAs as the independent rendering provider/billing provider. 

ARAPA is working closely with DHS on an interim plan. For now, Medicaid is recommending either billing/rendering services using the supervising physician's provider number or billing under a 95/NV provider type if you were previously enrolled under this. If you were previously seeing Medicaid patients and processing claims prior to July 1, 2024, you should revert to your billing process that was used prior to new rendering provider types that did not become active until July 1. 

We know there is a lot of confusion surrounding the changes, and it can be frustrating to see a pause in progress that we were proud to make this last year. However, ARAPA can assure you that we are working closely with DHS to ensure a smooth transition and will continue working hard to ensure it is done as fast as possible. We will updated members with any new information we receive, but in the meantime please do not hesitate to reach out with any questions to President Aaron Woodall and our Legislative Committee Co-Chairs.