** WELCOME TO THE **

     
     
   

These manuals do not address all the complexities of Medicaid policies and procedures, and must be supplemented with all State and Federal Laws and Regulations. 

Policies contained in the common chapters and appendices are applicable to all providers. Whereas, the policies in the Chapter 500 volumes are specific to that program.

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Table of Contents
Chapter 100 - General Information
Chapter 200 - Definitions
Chapter 300 - Provider Participation Requirements
Chapter 400 - Member Eligibility
Chapter 500 - Covered Services, Limitations, and Exclusions
Volume 1  - Aged & Disabled Waiver
Volume 2 - Behavioral Health Clinic
Volume 3 - Behavioral Health Rehabilitation 
Volume 4 - Chiropractic Services
Volume 5 - Dental Services
Volume 6 - DME/Medical Supplies
Volume 7  - ASC & Birthing Centers
Volume 8 - Home Health
Volume 9 - Hospice Services
Volume 10 - Hospital Services
Volume 11 - ICF/MR  Services
Volume 12 - Laboratory & Radiology
Volume 13 - MR/DD Waiver Services
Volume 15 - Nursing Facility Services
Volume 16 - Occupational/Physical Therapy
Volume 17 - Orthotics & Prosthetics
Volume 18  - Personal Care
Volume 19 - Pharmacy Services
Volume 20 - Practitioner Services
Volume 21 - Podiatry Services
Volume 22 - Psychological Services
Volume 23 - RHC FQHC Services 
Volume 25 - Targeted Case Management
Volume 26 - Transportation
Volume 27 - Vision Services
Chapter 600 - Reimbursement Methodologies 
Chapter 700 - General Administration
Appendices:
Appendix A - Medicaid Card
Appendix B - Sample Remittance Voucher
Appendix C - Prior Authorization Requirements
Appendix D - RBRVS
Appendix E - Third Party Liability
Appendix F - Estate Recovery
Appendix G - Subrogation
    Appendix H - Billing Instructions (New Claim Forms)
Appendix I - Provider Enrollment Agreement
Appendix J - Medicaid Fraud Control Unit/SURS
Appendix K - Provider Appeals
Appendix L - Beneficiary Appeals
Appendix M - Telephone Contact List