Provider News
Rhode Island Temporary State Imposed Moratorium for Newly Enrolling Hospice and Home Health Providers
Medicaid Provider Enrollment has instituted a six-month moratorium on newly enrolling Hospice and Home Health providers, effective from July 1, 2026, to January 1, 2027. No applications for enrollment will be approved for new hospice and home health providers during this six-month period. This moratorium does not impact any existing providers or newly enrolling providers that have already submitted an application for enrollment prior to July 1st.
Rhode Island Temporary State Imposed Moratoria for Home/Center Based Therapeutic Services and Applied Behavioral Analysis Providers
Rhode Island Medicaid has implemented a 6-month temporary moratorium on newly enrolled Home/Center Based Therapeutic Services and Applied Behavioral Analysis providers (HBTS/ABA). This will only impact newly enrolling HBTS/ABA providers starting on June 16, 2026.
If you have any questions, please contact your provider representative, Karen Murphy at karen.murphy3@gainwelltechnologies.com .
DMEPOS Provider Enrollment Moratorium
In alignment with federal guidance, RI Medicaid Provider Enrollment has instituted a six-month moratorium on newly enrolling Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) providers effective April 1, 2026. No applications for enrollment will be approved for new DMEPOS providers for a six-month period, starting April 1, 2026. This moratorium does not impact any existing providers or newly enrolling providers that have already submitted an application for enrollment prior to 4/1.
Immediate Denture Update
Immediate dentures are a covered benefit through RI Medicaid. Previously while providers awaited full rollout of these codes, they were allowed to bill the corresponding conventional denture codes in place of the immediate denture codes. The immediate denture codes can now be billed to RI Medicaid. Effective immediately, please bill accordingly using the immediate denture procedure codes. Those procedure codes are listed below:
| Code | Procedure |
Age Limitation |
Authorization Required |
Benefit Limitations |
| D5130 | immediate denture maxillary | No | No | One per lifetime per member |
| D5140 | immediate denture mandibular | No | No | One per lifetime per member |
| D5221 | immediate maxillary partial denture-resin base | No | No | One per lifetime per member |
| D5222 | immediate mandibular partial denture-resin base | No | No | One per lifetime per member |
Current Dental Terminology ©2024, American Dental Association. All rights reserved.
Please note that once an immediate denture has been delivered. The denture limitation will still apply. Members would be subjected to the 5-year limit once an immediate denture is delivered before they can receive a conventional denture. For example, if a member received D5130, they cannot receive D5110 until after 5 years of the immediate denture delivery.
Please contact RI provider Services at riproviderservices@gainwelltechnologies.com if you have any questions.
Opportunity for Financial Award – Transition Nursing Homes Beds to Assisted Living
EOHHS is pleased to announce a funding opportunity for non-profit nursing home providers interested in transitioning licensed nursing home beds to assisted living beds. This initiative supports providers in expanding access to community-based residential care and aligns with efforts to enhance options for older adults.
Providers who plan to transition nursing home beds to assisted living beds are eligible to apply for a financial award. The application window is open for one week, and all submissions must be received by close of business on May 14, 2025.
How to Apply:
Interested providers should compete the forms below and submit them via email to Deputy Medicaid Director John Bonin at John.bonin@ohhs.ri.gov.
If you have any questions or need further information, please contact chantele.rotolo@ohhs.ri.gov.
PROVIDER UPDATES
Provider Updates have been moved to another page.
Click here to be redirected.