What changes by state
- The conversion factor, which is often well below Medicare
- How time is counted and whether physical status is paid
- Whether CRNAs can enroll and bill directly
- How many managed care plans you deal with
Managed care plans
In most states, the majority of Medicaid patients are in managed care plans run by private insurers. Each plan has its own enrollment, its own rules and its own portal. Enroll with every plan your facilities see patients from, or those claims will deny.
Eligibility changes
Medicaid eligibility changes often. Check it close to the date of service, every time.
State details
Each of our state pages names the state's Medicaid program.
This article is general information, not billing, legal or tax advice. Payer rules change; always check current guidance.
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