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DOH Confirms Implementation of Universal Billing Codes

The Department of Health (DOH) has issued a letter confirming that universal billing codes for community-based long term care services are being implemented as scheduled beginning April 1, 2018. As of that date, Medicaid providers and Medicaid managed care plans, including Managed Long Term Care (MLTC) plans, are required to use universal billing codes approved by DOH. Additionally, after April 1st, plan payments to long term care service providers must be made via electronic funds transfer.

The codes being implemented are as published by DOH on Dec. 17, 2017. The Department has updated the APD/EIS system to accept the modifiers that will be required when submitting encounter claims and is currently updating the MMCOR guide.

The implementation confirmation letter is available here, and the Dec. 17, 2017 letter with codes is available here.

Contact: Darius Kirstein, dkirstein@leadingageny.org, 518-867-8841