New Provider Communication:

• DME
• Hearing Aid
• Nurse Practitioner
• Ordered Ambulatory
• Pharmacy
• Physician

New Provider Communication:

• Pharmacy

The Transportation Contact List has been updated. Please see:

• Transportation Contact List

New Provider Communication:

• Inpatient

New Provider Communication:

• Dental

The Preferred Diabetic Supply List (PDSL) formerly located in the Provider Communications Section has been removed for the following Provider Types. A link to First Health has been provided on the main manual pages in order to link to current PDSLs:

• Pharmacy
• Physician
• DME
• Nurse Practitioner
• Midwife

New Provider Communication:

• DME
• Pharmacy

The following Provider Maintenance Form was updated:

• Out-of-State Hospital Enrollment Package Request Form

Medicare Crossover FAQs were updated:

• Medicare Crossover Process Frequently Asked Questions

Modifications have been made to the following:

• MEVS Provider Manual
• Quick Reference Cards VeriFone Omni 3750
• Quick Reference Cards ARU

The Provider Enrollment section on this website has been re-designed in order to provide you with a more user-friendly approach to enrollment, maintenance forms and instructions. Please take a moment to browse the new "Provider Enrollment Portal" to become familiar with the location of forms you may need in the future, or, if you are considering enrolling in the program, take a tour!

Some key features:

• On the eMedNY home page, you will notice a new Provider Enrollment Tab at the top of the page. Also, note the link located on the upper left panel. These now go directly to Provider Enrollment. (Note - you may still arrive at Provider Enrollment by going to the Information Tab first.)
• Once you click on Provider Enrollment, you will come to a new Provider Enrollment "portal". There you will find an introduction to NY Medicaid, (a Provider Enrollment Guide), links to the Provider Maintenance Forms Page and links to new Rate Based Enrollment Form Web Pages for Institutional Providers.
• If you have any difficulty navigating, please contact the Call Center at (800) 343-9000.

The following Provider Enrollment Packets were updated:

• Physician Enrollment Packet
• Pharmacy Enrollment Packet
• Supervising Pharmacist Enrollment Packet
• Nurse Practitioner Enrollment Packet
• Registered Physician’s Assistant Enrollment Packet
• LPN/RN Nursing Enrollment Packet
• Podiatrist Enrollment Packet
• Dentist Enrollment Packet
• Clinical Psychologist Enrollment Packet
• Clinical Social Worker Enrollment Packet
• Chiropractor Enrollment Packet
• Therapist Enrollment Packet
• Self Employed Optician-Optometrist Enrollment Packet
• Hearing Aid Dealer Enrollment Packet
• Midwife Enrollment Packet
• Optical Establishment/Salaried Optician/Optometrist Enrollment Packet
• Laboratory Enrollment Packet
• Laboratory Director Enrollment Packet
• Certified Asthma Educatory (CAE)
• Certified Diabetes Educatory (CDE)

Privacy statements have been added to the paper remittance sections in the following billing guidelines:

• Assisted Living (ALP)
• Clinic
• Dental
• Inpatient
• Pharmacy
• Transportation

The following Provider Enrollment Packets were added:

• Laboratory Director Enrollment Packet
• Supervising Pharmacist Enrollment Packet

New Provider Communication:

• DME

The eMedNY Home Page has an exciting new look!! Please take a moment to view the new graphics and note that the left navigation panel opens. Also on the home page:

• The Notices Section has a scroll feature.
• New Provider Enrollment Tab and Left-side link (appears only on home page for now).
• Featured Links now appears under Notices in a more visible location.
• Disclaimer and Privacy Policy now in a more visible location.
• Note - all web pages that you are used to using are still in the same location.

New Provider Communication:

• Private Duty Nursing

New Provider Communication:

• DME
• Midwife
• Nurse Practitioner
• Physician

New Provider Communication:

• DME

Privacy statements have been added to the paper remittance sections in the following billing guidelines:

• Chiropractor
• Clinical Psychology
• Clinical Social Worker
• DME
• Laboratory
• Midwife
• Free Standing or Hospital Based Ordered Ambulatory
• Hearing Aid

MEDS II Data Element Dictionary updated for:

• Managed Care

Privacy statements have been added to the paper remittance sections in the following billing guidelines:

• Nurse Practitioner
• Private Duty Nursing
• Physician
• Podiatry
• Rehabilitation
• Vision Care

The following Provider Enrollment form was updated:

• LPN/RN Nursing Enrollment Packet

The following Provider Maintenance forms were updated:

• Certified Asthma Educator Enrollment Questionnaire
• Certified Diabetes Educator Enrollment Questionnaire
• Employment Certification for Certified Asthma Educator
• Employment Certification for Certified Diabetes Educator
• Application as a Specialist
• Request for Participation Group
• Medically Fragile Children PDN Rate Enhancement

New Provider Communication:

• DME
• Midwife
• Nurse Practitioner
• Pharmacy
• Physician

New Provider Communication:

• DME
• Midwife
• Nurse Practitioner
• Pharmacy
• Physician
• Podiatry

If you are a Home Health Care Provider, please let us know how we are doing by completing the online Home Health Satisfaction Survey.

Information for All Providers – Third Party Information has been updated. Please see:

• Information for All Providers - Third Party Information

An in-depth explanation of the policy relative to requests for prior authorization more than 90 days after the date of service has been added to the Transportation Policy Manual. Please see:

• Transportation Policy Manual

New Provider Communication:

• DME
• Pharmacy

New Provider Communications:

• Pharmacy

Modifications have been made to the following:

• DME 2009 Procedure Codes and Coverage Codes

New Provider Communication:

• DME

The Formulary File has been updated to accomodate a larger number for the Alternate Cost field:

• Formulary File

Modifications have been made to the following:

• ProDUR-ECCA Provider Manual
• ProDUR-ECCA Standards Manual

The following Provider Maintenance form has been added:

• Prior Conduct Questionnaire

Effective July 24, 2009 two important changes take effect in the NYS Medicaid Utilization Threshold (UT) Program. Please see the following Provider Letter:

• Utilization Threshold (UT) Update

Please review important UT information in the following guideline:

• Utilization Threshold Program

The following Pharmacy Policy Guidelines Manual has been updated, specifically the section related to copayments:

• Pharmacy Policy Guidelines

Third Party - Information for All Providers has been updated. New Prepaid Capitation Plan Added - Neighborhood Health Plan. Please see:

• Information for All Providers - Third Party Information

Third Party - Information for All Providers has been updated. The Key for the Prepaid Capitation Plan listing with information from the Office of Managed Care has been updated. Please see:

• Information for All Providers - Third Party Information

Modifications have been made to the following:

• DME 2009 Procedure Codes
• Pharmacy 2009 Procedure Codes

Modifications have been made to the following:

• MEVS Provider Manual
• ProDUR-ECCA Provider Manual
• ProDUR-ECCA Standards Manual

Claim Form eMedNY-150002 Billing Guidelines have been added to the following Provider Manuals.

• Clinical Psychology
• Clinical Social Worker
• Laboratory
• Podiatry
• Rehabilitation Services
• Vision Care

New Provider Communication:

• Hearing Aid

New Provider Communication:

• DME
• Pharmacy

Claim Form eMedNY-150001 Billing Guidelines have been archived for the following Provider Manuals:

• Midwife
• Ordered Ambulatory
• Nurse Practitioner
• Physician

Third Party - Information for All Providers has been updated. Managed Care Plan Codes were deleted. Please see:

• Information for All Providers - Third Party Information

The following Fee Schedule has been updated:

• Physician Fee Schedules Medicine

The Service Line section has been updated with screen shots showing where to enter NDC information in the following Claim Reference Guides:

• ePACES Institutional Claim Reference Guide
• ePACES Professional Claim Reference Guide
• ePACES Professional Real-time Claim Reference Guide

The following Transportation Prior Approval form replaces both the eMedNY 389701 and the Group form eMedNY 410601:

• Transportation Prior Approval Request Form - eMedNY 389702

The following 2009 Procedure Codes section has been updated:

• Transportation 2009 Procedure Codes

The following document has been updated to reflect the new CSC phone number:

• Out-of-State High Level Care (HLC) - Special Level of Care (SPC) Prior Approval Guidelines

The new Transportation Contact List has been added for the Transportation Manual Prior Authorization Guidelines. This document is a contact list for counties across the State.

• Transportation Contact List

Third Party - Information for All Providers has been updated. Insurance Code B5 description has changed and codes CV and ACA were removed. Please see:

• Information for All Providers - Third Party Information

New Provider Communication:

• DME

The DME Prescription Footwear Form was added to the following:

• DME Enrollment Packet

New Provider Communications:

• DME
• Pharmacy
• Physician
• Nurse Practitioner
• Nurse Midwife

Modifications have been made to the following:

• Posting Provider List

HCBS/TBI Waiver Services Manual Policy Guidelines have been updated. All information regarding the New York State Traumatic Brain Injury (TBI) Program is now available on the New York State Department of Health's website at http://www.nyhealth.gov/health_care/
medicaid/reference/tbi/. The policy manual has been updated to reflect this new website. Please see:

• HCBS/TBI Waiver Services

Third Party - Information for All Providers has been updated. New Insurance Codes added. Please see:

• Information for All Providers - Third Party Information

The following Provider Maintenance forms have been added:

• Clinic Certification of Staff Certified as Asthma Educators
• Clinic Certification of Staff Certified as Diabetes Educators

Third Party - Information for All Providers has been updated. Please note the Key for the Prepaid Capitation Plan listing with information from the Office of Managed Care was updated. Please see:

• Information for All Providers - Third Party Information

The following document that addresses new HIPAA regulations has been added to the Notifications section:

• HIPAA-2 Announcement

Claim Form eMedNY-150002 Billing Guidelines have been added to the following Provider Manuals.

• Midwife
• Ordered Ambulatory
• Nurse Practitioner

The following 2009 Fee Schedule has been updated:

• Dental Fee Schedule

Zip + 4 added to the Application Form address for the following:

• Electronic/Paper Transmitter Identification Number (TSN/Provider)
• Electronic Transmitter Identification Number (TSN/Service Bureau)

The following Provider Maintenance forms have been added in order to allow already enrolled Fee for Service Providers to have the appropriate specialty code added to their file:

• Certified Asthma Educator Enrollment Questionnaire
• Employment Certification for Certified Asthma Educator
• Certified Diabetes Educator Enrollment Questionnaire
• Employment Certification for Certified Diabetes Educator

New Provider Communications:

• Clinical Psychology
• Hearing Aid
• Midwife
• Nurse Practitioner
• Physician
• Rehabilitation Services
• Vision Care

The following 2009 Fee Schedules and Procedure Codes sections have been updated and reposted:

• Physician Drugs 2009 Fee Schedule
• Physician Medicine 2009 Fee Schedule
• Physician Radiology 2009 Fee Schedule
• Physician Surgery 2009 Fee Schedule
• Hearing Aid 2009 Fee Schedule
• Vision Care 2009 Fee Schedule
• Midwife 2009 Fee Schedule
• Nurse Practitioner 2009 Fee Schedule