MedicaidBilling CodesMedium impact
CHW Provider Letter Non-Dental
Kentucky Medicaid·KY · Family Medicine, Internal Medicine, General Practice +2 more·Provider Letter
Effective date
Jul 1, 2023
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid is introducing new Community Health Worker (CHW) services with three billable CPT codes starting July 1, 2023. The services have specific reimbursement rates based on group size and are limited to 2 units per week and 104 units per year per member.
Action Required
By July 1, 2023: Billing team must add new CPT codes 98960, 98961, and 98962 to billing system with Kentucky Medicaid reimbursement rates ($22.53, $10.88, and $8.03 per patient per 30-minute increment respectively). Configure system to enforce limitations of maximum 2 units per member per week and 104 units per calendar year. Update encounter forms for eligible provider types to include CHW service options.