MedicaidPrior AuthMedium impact
Assessment Rates Allowance Ancillary Change
Kentucky Medicaid·KY · Physical Therapy, Occupational Therapy·Provider Letter
Effective date
Jul 1, 2024
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid eliminated prior authorization requirements for ancillary services (Physical Therapy, Occupational Therapy, Speech Therapy, Oxygen Therapy and supplies) at nursing facilities effective July 1, 2024. Price-based nursing facilities will now receive $0 reimbursement for separately billed ancillary services as these are included in their per diem rates.
Action Required
Immediately: Billing teams at nursing facilities must stop submitting separate claims for ancillary services (PT, OT, Speech Therapy, Oxygen Therapy, supplies, x-ray, lab) if they are price-based facilities receiving quarterly case mix adjustments under 907 KAR 1:065. Update billing system to prevent submission of these ancillary service claims as they will be zero-paid. Non price-based facilities can continue billing ancillary services normally without prior authorization.