MedicaidCoverageMedium impact
Provider Letter - Goods and Services Update
Kentucky Medicaid·KY · Physical Therapy, Occupational Therapy·Provider Letter
Effective date
Oct 31, 2018
We identified it
Jun 20, 2026
Summary
Kentucky Medicaid clarifies that 1915(c) waiver programs are payers of last resort for goods and services. Providers must first seek coverage through DME fee schedules, Medicaid State Plan, or EPSDT for participants under 21 before requesting items through waiver programs.
Action Required
Immediately: Billing team must establish workflow to verify DME fee schedule coverage and Medicaid State Plan benefits before submitting requests to 1915(c) waiver programs. For participants under 21, route all goods and services requests through EPSDT first by contacting DMS Division at (502) 564-9444. Upload any denial letters to MWMA when submitting waiver requests after other funding sources are exhausted.