Limitations on Medicare Part B Coinsurance

Medicaid presently pays practitioners the full Medicare Part B annual deductible and partial Medicare Part B coinsurance amounts (20 percent of the Part B coinsurance) for Medicaid covered services provided to Medicare/Medicaid dually eligible recipients. However, the full Medicare Part B coinsurance amount is reimbursed for procedures if the service is not covered by Medicaid. This payment policy is changing. Effective October 1, 2011, NY Medicaid will no longer reimburse practitioners any portion of the Medicare Part B coinsurance amount if the service is not covered by Medicaid.