Is it permissible for states with Medicare geographic adjustments that opt to develop rates based

We believe this would be acceptable. However, the Centers for Medicare & Medicaid Services (CMS) would review the methodology as part of the SPA approval process.

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This FAQ was released as part of a larger set. View the full set. (PDF, 54.7 KB)

Date

Sun, 01/27/2013 - 12:00

Topic

Medicaid and CHIP Program (MACPro)

Affordable Care Act

Sub Topic

Final Rule

Medicaid Expansion

Primary Care Services

FAQ ID

92716

FAQ Page

Frequently Asked Questions

FAQ Question

Is it permissible for states with Medicare geographic adjustments that opt to develop rates based on the mean Medicare rate over all counties for each Evaluation & Management code under CMS 2370-F to use a weighted mean based on either the county population or the county Medicaid enrollment?