From time to time, the Kentucky Department for Medicaid Services (KDMS) updates fee schedules for existing published codes and modifiers allowable for Kentucky Medicaid enrollees. Humana Healthy Horizons® in Kentucky does not adjust previously paid claims in accordance with retroactive fee schedule modifications issued by the KDMS.
We publish the date we update our claims adjudication system to the new rate. You’ll find the current configuration below in the Published Fee Schedule Notices section.
In the circumstance a modification to the KDMS fee schedule is the addition of a new code or modifier, Humana will adjust previously adjudicated claims impacted by such a modification in accordance with any applicable retroactive effective date.
Reimbursement of published fee schedules are subject to provisions within in-network provider contract agreements and the
The following provider types are included in this policy:
- Advanced Registered Nurse Practitioner (ARNP) - 78, 789
- Ambulatory Surgical Centers - 36
- Audiologist - 70, 709
- Behavioral Health Multi-Specialty Group - 66
- Behavioral Health Services Organization - 03
- Birthing Centers - 73
- Certified Registered Nurse Anesthetist (CRNA) - 74, 749
- Chiropractor - 85, 859
- Community Mental Health Centers - 30
- Comprehensive Outpatient Rehabilitation Facilities - 91
- Dentist - 60, 61
- Early Periodic Screening Diagnosis and Treatment Services - Screenings - 45
- Early Periodic Screening Diagnosis and Treatment Services - Special Services - 45
- Emergency Transportation - 55
- Family Planning Services - 32
- FQHC/Non-FQHC - 31
- Hearing Aid Dealer - 50, 509
- Home Health Services - 34
- Hospice Services - 44
- Hospitals - 01
- Independent Laboratory and Radiological Services - 37
- Licensed Behavioral Analyst - 63, 639
- Licensed Clinical Alcohol and Drug Counselor - 67, 679
- Licensed Clinical Social Worker - 82, 829
- Licensed Marriage and Family Therapist - 83, 839
- Licensed Professional Art Therapist - 62, 629
- Licensed Professional Clinical Counselor - 81, 819
- Licensed Psychological Practitioner - 84, 849
- Licensed Psychologist - 89, 899
- Multi Therapy Agency - 76
- Non-Emergency Transportation - 56
- Nursing Facility - 12
- Occupational Therapist - 88, 889
- Optician - 52, 529
- Optometrist - 77, 779
- Physical Therapist - 87, 879
- Physician Assistant - 95, 859
- Physician Services - 64, 65
- Podiatry Services - 80, 809
- Primary Care - 31
- Private Duty Nursing (PDN) - 18
- Psychiatric Distinct Part Unit (DPU) - 92
- Psychiatric Hospital - 02
- Psychiatric Residential Treatment Facility I - 04
- Psychiatric Residential Treatment Facility II - 05
- Radiological Services and other Lab and X-Ray - 86
- Rehabilitative Distinct Part Unit (DPU) - 93
- Renal Dialysis Service - 39
- Residential Crisis Stabilization Unit - 26
- Rural Health Services - 35
- Specialized Children's Services Clinic or Child Advocacy Centers - 13
- Speech-Language Pathologist - 79, 799
- Targeted Case Management and Rehab Services provided through Title V Services – 23
Published Fee Schedules to be posted upon policy effective date.