Colorado Children’s Healthcare Access Program: Practice Manager Newsletter

“Medicaid 2015 fee schedule update - Increase in Payment for Office Visits and Vaccine Administration: Beginning January 1, 2015, Colorado Medicaid is reimbursing covered office visit (E&M) and vaccine administration procedure codes at a rate equal to 100% of the December 2014 Medicare reimbursement rate. The new rate is available to all enrolled providers that submit fee schedule claims for office visits or vaccine administrations. The new reimbursement rate will remain in place through June 30, 2016. Click here for the fee schedules.

Due to a delay in CMS approval of the new rates, the higher rates have not yet been loaded in the Medicaid claims processing system.  Medicaid does not have an anticipated approval date at this time. Medicaid will retroactively adjust claims with dates of service on or after January 1, 2015, to reflect the rate increase. Providers should continue to submit charges based on Usual and Customary rates, when applicable.  Automatic adjustments can be made by the Medicaid claims system only if the original submitted charge on a claim is greater than the newly revised rate; otherwise, the provider must resubmit a claim with the higher rate. Once CMS approval is received, the new rates will be loaded and will be paid upon claim submittal.

Check out the CCHAP Practice Manager Newsletter for more information on:

• Next CCHAP Practice Manager Meeting
• New CCHAP website
• Quick Reference Preventive Screening Coding Table
• ECHO for Children and Youth with Epilepsy
• New CCHAP Attribution Scrubbing Tool” [Source: CCHAP]