MedicaidReimbursementMedium impact
MSRP vs Invoice Billing
Kentucky Medicaid·KY · Orthopedics, PM&R (Physical Medicine & Rehab), Wound Care·Coding
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid has clarified reimbursement rates for medical supplies, equipment, and appliances (MSEA). Standard items are reimbursed at manufacturer suggested retail price (MSRP) minus 18%, while customized items or items without MSRP are reimbursed at invoice cost plus 20%.
Action Required
Immediately: Kentucky MSEA providers must verify billing practices align with reimbursement structure - bill standard medical supplies/equipment at MSRP minus 18%, and customized items or items without MSRP at invoice plus 20%. Review current claims to ensure proper pricing methodology is being used for Kentucky Medicaid submissions.