Billing Beat

Medicaid reimbursement methodology change

December 30, 2015

Pursuant to 2015 changes to Social Services Law, the NYS Department of Health is revising the Medicaid reimbursement methodology for claims containing Medicare Part B services/supplies. Effective January 1, 2016, Medicaid will no longer reimburse partial Medicare Part B coinsurance amounts when the Medicare payment exceeds the Medicaid fee or rate for that service. This change is retroactive to July 1, 2015 and applies to Medicare Part B services.

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