MedicaidCoverageMedium impact
DME Additions to Fee Schedule
Kentucky Medicaid·KY · Orthopedics, General Surgery, Wound Care·Reimbursement
Effective date
Dec 1, 2023
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid has added three new DME items to their fee schedule: sterile gloves (A4930), non-sterile gloves (A4927), and disposable wipes (A9286). These items are reimbursed at MSRP minus 18% and require prior authorization and Certificate of Medical Necessity.
Action Required
Immediately: Billing team must update system to include new DME codes A4930, A4927, and A9286 for Kentucky Medicaid patients. Configure reimbursement calculation as MSRP minus 18%. Set up prior authorization requirements and Certificate of Medical Necessity workflow for these codes. Update encounter forms and inform providers of new coverage.