Medicaid Affordable Care Act Enhanced Rates Expire for Services Furnished by Certain Primary Care Physicians

The Division of Medicaid and Health Financing’s enhanced rates for services furnished by certain primary care physicians authorized by the Affordable Care Act (ACA) does not apply to services rendered on or after January 1, 2015. ACA allowed for enhanced rates up to the Medicare physician fee schedule for services rendered in calendar years 2013 and 2014. If claims are submitted timely, enhanced payments for services will continue for all covered services rendered during calendar years 2013 and 2014.

For more information on the enhanced rates, please refer to CMS-2370-F as published in the Federal Register on November 6, 2012.

Questions or comments may be sent to the Reimbursement Unit, Utah Department of Health, P.O. Box 143102, Salt Lake City, UT 84114-3102.