The Department for Medicaid Services covers items such as wheelchairs, orthotic appliances and disposable medical supplies when ordered by an approved prescriber and are medically necessary. If your pharmacy is enrolled as a Medical Supplies, Equipment and Appliance (MSEA) provider (PT90), you may bill covered nutritional supplements and disposable supplies as a medical benefit under provider type 90. Reimbursement amounts are listed in the Medicaid MSEA Fee Schedule and defined in 907 KAR 1:479. Billing and enrollment instructions are available online. For children under 21 years of age, an item not listed on the MSEA fee schedule may be covered under Early Periodic Screening Diagnosis and Treatment Services (EPSDT) Special Services which requires prior authorization. For assistance, please contact the EPSDT Special Services Coordinator at ivy.sams@ky.gov.
For more information, contact NACDS’ Jill McCormack at 717-592-8977.