September 19, 2013

State of Alabama
Press Release: Medicaid

Reimbursement Change 7.5 Percent Reduction

TO:     All Physicians and Independent Certified Registered 
            Nurse Practitioners (CRNP)

Due to budget constraints, the Alabama Medicaid Agency will implement a 7.5 percent reduction in payments to all physicians, physician-employed nurse practitioners, physician-employed physician assistants, and to CRNPs. 

Primary care provider rates for the evaluation and management (E&M) and Vaccine for Children (VFC) procedure codes under the Affordable Care Act will not be affected, but all other procedure codes will be reduced.  Primary Care providers who qualify for the Primary Care Rate increase (also called BUMP increase) and have an attestation form on file with HPES will continue to be reimbursed at 100 percent for the E&M and VFC codes.   

These reductions will be effective for dates of service on or after October 1, 2013.


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