MedicaidPrior AuthMedium impact
DME Incontinence Supplies Update
Kentucky Medicaid·KY · Urology, OB-GYN, Family Medicine +3 more·Provider Letter
Effective date
Sep 15, 2023
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid removed prior authorization requirements for incontinence supplies effective 09/15/2023 and increased reimbursement rates for multiple HCPCS codes. Two new reusable underpad codes (T4537, T4540) were added to the DME fee schedule for patients age 3 and up.
Action Required
Immediately: Billing team must update fee schedules with new rates for 14 incontinence supply codes and add two new codes (T4537 at $21.00 each, limit 6/year; T4540 at $16.00 each, limit 6/year). Remove prior authorization requirements for all incontinence supplies but ensure claims include diagnosis of fecal or urinary incontinence. Update billing system to restrict coverage to patients age 3 and up under DME Provider type 90.