Fee schedules

Female doctor talking with male nurse

From time to time, the Kentucky Department for Medicaid Services (Kentucky DMS) 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 Kentucky DMS.

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 event a modification to the Kentucky DMS fee schedule includes the addition of a new code or modifier, Humana adjusts previously adjudicated claims impacted by such a modification in accordance with all applicable retroactive effective date.

Reimbursement of published fee schedules are subject to provisions within in-network provider contract agreements and the Out of Network Claims Payment Policy, PDF.

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

Thank you for the high-quality care you provide your patients with coverage through Humana Healthy Horizons in Kentucky.

Published fee schedule notices

Ambulatory surgical center (ASC) services
KDMS ASC fee schedule system configuration effective 8/13/2023, PDF.

Audiology
KDMS audiology fee schedule system configuration effective 8/13/2023, PDF.
KDMS audiology fee schedule system configuration effective 8/24/2023, PDF.
KDMS audiology fee schedule system configuration effective 11/14/2023, PDF.

Behavioral health
KDMS behavioral health fee schedule system configuration effective 8/13/2023, PDF.

Chiropractor
KDMS chiropractor fee schedule system configuration effective 8/13/2023, PDF.

Clinical laboratory
KDMS clinical laboratory fee schedule system configuration effective 8/13/2023, PDF.
KDMS clinical laboratory fee schedule system configuration effective 8/14/2023, PDF.

COVID-19 antibody infusion therapy
KDMS COVID-19 antibody infusion therapy fee schedule system configuration effective 8/13/2023, PDF.

Dental
KDMS dental fee schedule system configuration effective 8/13/2023, PDF.
KDMS dental fee schedule system configuration effective 8/24/2023, PDF.

Durable medical equipment (DME)
KDMS DME fee schedule system configuration effective 8/13/2023, PDF.
KDMS DME fee schedule system configuration effective 8/24/2023, PDF.
KDMS DME fee schedule system configuration effective 10/4/2023, PDF.

Home health
KDMS home health fee schedule system configuration effective 8/13/2023, PDF.

Hospice
KDMS hospice fee schedule system configuration effective 8/13/2023, PDF.

Nursing facility laboratory
KDMS nursing facility laboratory fee schedule system configuration effective 8/13/2023, PDF.

Occupational therapy
KDMS occupational therapy fee schedule system configuration effective 8/13/2023, PDF.

Physical therapy
KDMS physical therapy fee schedule system configuration effective 8/13/2023, PDF.

Physician
KDMS physician fee schedule system configuration effective 8/13/2023.
KDMS physician fee schedule system configuration effective 8/14/2023.
KDMS physician fee schedule system configuration effective 8/24/2023.
KDMS physician fee schedule system configuration effective 10/6/2023.

Physician administered drug (PAD) list
KDMS PAD fee schedule system configuration effective 8/13/2023, PDF.

Private duty nursing supplies
KDMS private duty nursing supplies fee schedule system configuration effective 8/13/2023, PDF.

Preventive health
KDMS preventive health fee schedule system configuration effective 8/13/2023, PDF.
KDMS Preventive Health fee schedule system configuration effective 10/6/2023, PDF.

Radiology
KDMS radiology fee schedule system configuration effective 8/13/2023 , PDF.

Renal dialysis – Medicare Part B drugs
KDMS renal dialysis – Medicare Part B drugs fee schedule system configuration effective 8/13/2023, PDF.

Speech therapy
KDMS speech therapy fee schedule system configuration effective 8/13/2023, PDF.

Transportation
KDMS transportation fee schedule system configuration effective 8/13/2023, PDF.

Vision
KDMS vision fee schedule system configuration effective 8/13/2023 , PDF.