Medicaid Primary Care Rate Increase (PCRI)
In order to receive the PCRI, qualified providers must attest that they meet the requirements of the regulation. The attestation instructions and enrollment forms for physicians, nurse practitioners, and midwives can be found at www.emedny.org/info/ProviderEnrollment.
As provider attestations are filed and approved, updates will be posted to this site. If you would like to be notified of these updates, please sign up for the Listserv below.
December 2, 2013 list of providers:
- Physicians List (EXCEL, 2.0 MB)
- PCRI PowerPoint: Qualification, Attestation and Payment (PDF, 1MB, 24pg.)
- Frequently Asked Questions (FAQs) (PDF)
- CMS Rule (released November 2012)
- Listserv (information updates)
- Managed Care
July 15, 2013
Medicaid Primary Care Rate Increase is Here!
New York State received State Plan Amendment (SPA #13-04) approval on May 30, 2013 from CMS to implement the PCRI. Fee for service payment began within payment cycle 1872 (July 4, 2013).
Beginning in September 2013, eMedNY will reprocess claims for dates of service on and after January 1, 2013 at the increased rate to providers who have submitted complete attestations by August 1, 2013. For attestations received after August 1, 2013, the increased rate will be paid effective the date the attestation is received.
Further information on managed care implementation will be forthcoming.
- PCRI Fee Schedules:
- PCRI FAQ's, webinar presentation and attestation form
- Fee-for-service Medicaid billing assistance: CSC, (800) 343-9000.