2015 Medicaid Primary Care Rate Increase

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2015 Medicaid Primary Care Rate Increase

Friday, January 23, 2015

For 2015 the primary care rate increase will be paid on CPT codes (99201 through 99215; 99304 through 99318; 99324 through 99337; 99341 through 99350) for physicians Board certified in family medicine, general internal medicine, or pediatric medicine. The fee-for-service and non-capitated managed care plans will pay the enhanced payment through CPT codes. However, if your managed care contract is capitated, the increase will come as an enhanced capitated payment. While MSMS has not be told he amount for that enhanced payment, MSMS learned that it is on par with the fee-for-service increase.

Because the enhanced payment has not been disclosed, please work with the health plans to define the enhanced capitated payment. As you contact the health plans to determine that enhanced capitated payment, please verify with them your specialty as the state will not provide an eligibility roster to the health plans.

Should you have any further questions, please contact your reimbursement and coding solution, Stacie Saylor, CPC, CPB, at (517) 336-5722 or ssaylor@msms.org.