Health care providers who deliver home infusion care to UnitedHealthcare Community Plan of Kentucky Medicaid members must register as both a pharmacy provider (PT 54) and a durable medical equipment (DME) provider (PT 90).
Specialty pharmacies that bill UnitedHealthcare Community Plan of Kentucky for nursing, administration or supplies must also register as a DME provider (PT 90) with Kentucky Medicaid.
When we adjudicate these claims, the provider’s billing NPI and taxonomy will be compared to the Kentucky Medicaid provider enrollment file. The following will result in a claim denial:
If nursing, administration or supplies claims are received with the appropriately registered DME taxonomy (PT 90) on the CMS-1500 form, the claim will be forwarded for further adjudication.
For additional information, please reference the Kentucky Injectable Drug List and the MedImpact prior authorization form.
View the Kentucky Care Provider Manual for additional information or call Provider Services at 800-666-1353.