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PCRI Payment Deadline Approaches

The Affordable Care Act established a Medicaid Primary Care Rate Increase (PCRI) for specific primary care services, including E&M codes 99201-99499 and certain vaccine administration codes covered by Medicaid managed care plans. The increase will result in payment of primary care services at the Medicare rate to qualified Medicaid providers from January 1, 2013 through December 31, 2014. CDPHP will make quarterly payments to comply with the schedule established by New York state.

To qualify, physicians and mid-levels must attest to their status as a PCP, supported by either board certification or an appropriate claims history. Attestation forms may be found at the eMedNY website