Attestation Begins For Medicaid Primary Care Pay Increase

On December 28th, Indiana Health Coverage Programs released a bulletin which details how physicians can qualify for a temporary increase in Medicaid payments.

From January 1, 2013 to December 31, 2014 when a family physician sees a Medicaid patient the physician can receive payment at Medicare rates for the following codes:

  • E/M codes 99201 through 99499
  • Vaccine administration codes 90460, 90461, 90471, 90473 and 90474

To qualify physicians must be in the specialty of family medicine, pediatrics, or general internal medicine; and be either board certified in their specialty OR have at least 60% of the codes billed by the physician to Medicaid be in the 99201-99499 or 90471-90474 ranges.

Physicians who provide services through Federal Qualified Health Centers or Rural Health Clinics do not qualify for the increase.

To receive the pay increase physicians must fill out this form to attest that they qualify for the payment increase. Send attestation forms to:
HP Provider Enrollment P.O. Box 7263 Indianapolis, IN 46207-7263

Physicians whose attestation forms are received prior to January 31st, 2013, will be eligible retroactively to January 1st, 2013. Those physicians whose attestation forms are received after January 31st will be eligible from the date their attestation form was received on forward.

You will need the following information to fill out the attestation form:

  1. Your National Provider Identifier (NPI) and your Medicaid Legacy Provider Identifier (LPI)
  2. Your specialty number and name
    Family Medicine’s specialty number is 316 and specialty name is Family Practitioner
  3. Your effective date and expiration date of board certification, if attesting through board certification
  4. Your Tax Identification Number (TIN) of your practice. This may be your social security number if you are a sole proprietorship.

For more information see the December 28th bulletin and the IAFP’s article from November 28th