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Welcome to Idaho Medicaid

 Announcements

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6/15/2017
L8680 - Implantable neurostimulator electrodeUse SHIFT+ENTER to open the menu (new window).

Effective for date of service July 1, 2017, and forward, HCPCS code L8680 - Implantable neurostimulator electrode, is non-covered by Idaho Medicaid. Medicare has incorporated L8680 into CPT 63650 - Percutaneous implantation of neurostimulator electrode array, epidural, and adjusted the pricing. Providers should not bill L8680 in conjunction with a lead implantation procedure; L8680 has been removed from the Medicaid covered services schedule. For more information concerning L8680, see MLN Matters MM8645 April 1, 2014.

6/15/2017
CPT 43647 - Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes Use SHIFT+ENTER to open the menu (new window).

Effective date of service July 1, 2017, and forward, CPT 43647 - Laparoscopy, surgical; implantation or replacement of gastric neurostimulator electrodes, will be non-covered by Idaho Medicaid. This medical procedure is deemed investigational in nature according to the benchmarks used by Idaho Medicaid to determine coverage.

6/6/2017
June MedicAide Newsletter Now OnlineUse SHIFT+ENTER to open the menu (new window).

The June edition of the MedicAide Newsletter is now available online. Please click here for the latest news and information affecting Idaho Medicaid providers. If you must receive the MedicAide by mail, please dial 1 (866) 686-4272 and select option 3.

6/6/2017
Trading Partner Account (TPA) Portal UpgradeUse SHIFT+ENTER to open the menu (new window).

The Trading Partner Account (TPA) portal is being upgraded to a new version in Fall 2017.  This upgrade will result in a new look and feel and new features to enhance communication. 

 

After the upgrade, all providers will need to have a TPA to access enrollment, maintenance, and training.  If you do not currently have a Trading Partner Account, register for one now at www.idmedicaid.com.  Detailed instructions on how to register can be found in the Trading Partner Account (TPA) User Guide.

 

More information on the upcoming upgrade can be found in the June 2017 MedicAide newsletter.

 

5/9/2017
Ordering, Referring, and Prescribing (ORP) RequirementsUse SHIFT+ENTER to open the menu (new window).

Idaho Medicaid requires the name and the National Provider Identifier (NPI) of the health care professional that ordered, referred, or prescribed (ORP) the items or services being submitted on a claim to Medicaid.  If the ORP provider’s information is not listed on a claim, or if the ORP provider is not enrolled with Idaho Medicaid, the billing provider will not receive reimbursement.  This means that health care professionals not currently enrolled with Idaho Medicaid will need to submit an application.  There is an abbreviated application process for providers who do not submit claims to Medicaid but who must enroll as ordering, referring, certifying, or prescribing providers.  The Ordering, Referring, and Prescribing Enrollment Application can be found here. 

 

Further details regarding this requirement were published in the April 2017 MedicAide newsletter.

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