MedicaidAdministrativeMedium impact
Medicaid copayments
Wisconsin Medicaid (ForwardHealth)·WI·Medical Policy
Effective date
Jan 1, 1998
We identified it
Jun 20, 2026
Summary
Wisconsin Medicaid updated copayment amounts to federal maximums effective January 1998, with specific copayment rates for different services ranging from $0.50 to $3.00. Providers must collect copayments when billing but cannot deny services if patients cannot pay, and copayments are automatically deducted from Medicaid reimbursements.
Action Required
Wisconsin providers must: 1) Update billing systems with current Medicaid copayment rates ($0.50-$3.00 based on service type and fee amounts), 2) Train staff that copayments cannot be grounds for denying services, 3) Ensure billing at usual/customary rates as copayments are automatically deducted by Medicaid, 4) Implement processes to refund overpaid copayments to recipients, 5) Download current fee schedules from EDS-EPIX system to determine correct copayment amounts.