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August 24, 2006
 
MEDICAID INFORMATION RELEASE MA06-32
 
TO:                 Aging and Disabled Services Providers (A&D), Independent RN & LPN Providers (Independent),  Nursing Agencies (Agency), DD/ISSH Waiver Providers (Independent or Agency), School Based Service Providers (SBS), Mental Health Clinics (MHC),  Rehab Mental Health Providers (RMH), PWC (Pregnant Women & Children) Providers (PWC).
 
FROM:           Leslie M. Clement, Administrator
 
SUBJECT:     INCREASES IN REIMBURSEMENT RATES FOR CERTAIN NURSING SERVICES
 
Effective for dates of service on or after 10/1/2006, Idaho Medicaid will increase reimbursement rates for the following Nursing Services procedure codes in order to better align reimbursement rates with prevailing
wage rates.
 
CODE
MOD
ProVIDER
Service DESCRIPTION
New Rate
T1000
 
Independent
Private Duty Nurse – Individual RN   1 unit = 15 min
$6.12
T1000
TE
Independent
Private Duty Nurse – Individual LPN   1 unit = 15 min
$4.16
T1001
TD
Agency
Private Duty Nurse – Agency RN  1 unit = 15 min
$7.65
T1000
 
Agency
Private Duty Nurse – Agency LPN    1 unit = 15 min
$5.20
T1001
 
Independent or Agency
RN Oversight of LPN Visits – Per Visit
$35.59
T1001
 
MHC, RMH
Nursing Assessment – Evaluation    1 unit = 15 min
$11.12
T1001
U5
PWC
Nursing Assessment – Evaluation  (PWC Maternity Nursing Services)
$35.59
T1001
U8/TD
Independent
Nursing Oversight – Independent   RN Visit
$35.59
T1001
U8/TD
Agency
Nursing Oversight – Agency   RN Visit
$44.49
T1000
U8
 Independent
Private Duty  Skilled Nursing – RN – Independent
1 unit = 15 min
$6.12
T1000
U8/TE
Agency
Private Duty Skilled Nursing - LPN - Agency
 1 unit = 15 min
$5.20
T1000
U8/TD
Agency
Private Duty Skilled Nursing - RN - Agency
 1 unit = 15 min
$7.65
T1001
U8
Independent or Agency
RN Oversight of LPN Visits – Per Visit
$35.59
T1002
 
Agency, SBS
Nursing Services by RN  1 unit  = 15 min
$7.65
T1002
TD
SBS
Nursing Services by RN  1 unit  = 15 min
$7.65
T1002
U2
A&D
Nursing Services by RN  1 unit  = 15 min
$7.65
T1003
 
A&D, SBS
Nursing Services by LPN  1 unit  = 15 min
$5.20
 
If you have any questions please contact Eric Anderson, Senior Financial Specialist for the Medicaid Office of Reimbursement Policy, at (208) 364-1918.  Thank you for your continued participation in the Idaho Medicaid program.
 
LMC/ea/sw