Provider News

Bridge Closure/Late Fees for RI Medicaid Recipients

Please be advised that RIDOT has closed the westbound side of the Washington Bridge/I-195 West due to the discovery of the critical failure of some bridge components.  To ensure ongoing access to needed care and services, providers are reminded that imposing late fees, balance billing, and/or termination of beneficiaries who miss or are late to appointments due to the bridge closure is not allowable. We ask that providers support and accommodate beneficiaries affected by this closure to ensure that needed care and services are delivered timely. 

Kristin Sousa, Medicaid Program Director 
 

Substance Abuse Residential Providers

Changes to the Medicaid Fee for Service (FFS) billing for SUD Residential was implemented in December 2024. 

These new codes have a retro effective date of October 1, 2024.  SUD Residential services will continue to be billed to RI Medicaid FFS on the 837 Professional transaction or the paper CMS 1500 claim form.  SUD Residential claims will be billed with Taxonomy 324500000X – Residential Treatment Facility.

RI Medicaid/OHHS recouped all billing (of codes H0001 UD, H0004 UD, H0005 UD) from 10/1/2024 through mid-December.  This recoupment was posted on the Remittance Advice dated December 27, 2024.  If you have billed a BLOCK Grant, the recoupment will be handled separately at a later date.   

For services from 10/1/24 onward, providers must rebill these services with the new code combinations, to receive the new per diem rates effective 10/1/24.

For any questions, please feel free to contact Provider Representative, Karen Murphy at karen.murphy3@gainwelltechnologies.com or 571-348-5933.

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