Medicaid Renewals Medicaid renewals began again in Rhode Island on April 1, 2023. For more information, please visit staycovered.ri.gov.
Fee Schedules Pediatric Physician Rate Increase RI Medicaid has implemented a rate increase to allow physicians billing for recipients under the age of 21 years to receive rates equivalent to Medicare. This rate increase will be retro-actively effective for dates of service on or after July 1, 2022. Providers should update their billing systems to reflect the new rates in order to be reimbursed correctly.The new rates can be viewed on the bottom of the Physician Directory page. Below are the links to the Medicaid Fee Schedules. Interactive Fee for Service Fee Schedule Interactive Outpatient Pricing Fee Schedule (NOT APC Pricing)* * NOTE: This is NOT the APC Fee Schedule/See Outpatient Hospital Fee Schedules for APC Fee Schedule. Please Note: There are circumstances that may impact pricing such as: manual pricing, provider-specific certification/pricing, or multiple surgical procedure codes. When the rate is listed as $0, then the claim is priced manually and requires supporting documentation. Pricing Action Code (PAC) values are: Blank - Base Medicaid I - Informational M - Manual P - Percentage S - Special modifier pricing Fee schedule information will be updated to the web on a weekly basis. Fee schedule data will span the last three years. For additional information or questions, please contact the Customer Service Help Desk at 401-784-8100. Eleanor Slater Hospital Rates 2019-Interim Proposed I/DD rates- effective 10/1/19 EOHHS responses to public comments regarding Independent Provider rates Home Stabilization - Emergency Case Management during COVID-19 Crisis National Correct Coding MUE Data DME Providers Outpatient Hospitals, Outpatient Psych, and DialysisAmbulatory Surgical Centers and Professional Providers Outpatient Hospital Fee Schedules For the following items, visit the Hospital Provider Directory page APC Fee Schedule 2022 Updated August 2022 APC Fee Schedule 2021 APC Fee Schedule 2020 APC Fee Schedule 2019 APC Status Codes Frequently Asked Questions Laboratory Procedure Codes Updated October 2022 Radiology Procedure Codes Updated October 2022 All Patient Refined Diagnosis Related Groups (APR-DRGs) RI DRG Calculator July 1, 2022 RI DRG Calculator (older versions) Frequently Asked Questions J Codes Requiring NDC J Code Conversion Table Updated February 2023 Users can print individual PDF by selecting the PDF and then indicating what page(s) to print.