The mission of KPhA is to advocate and advance the pharmacy profession to improve the health of Kentuckians.

Blog

Medicaid Announces Coverage of At-Home COVID Tests

Kentucky Medicaid will now reimburse pharmacies for at-home COVID-19 Rapid Antigen test kits through Point of Sale for Medicaid members. Below you will find the billing guidance and a list of covered NDCs. DMS will work to keep this list updated as new products become available.
Kentucky Medicaid will now reimburse pharmacies for at-home COVID-19 Rapid Antigen test kits through Point of Sale for Medicaid members. Below you will find the billing guidance and a list of covered NDCs. DMS will work to keep this list updated as new products become available.
  • Reimbursement for the test kits will be paid according to the payment algorithm in the Kentucky Medicaid Pharmacy Provider Point-of-Sale (POS) Billing Manual.
  • The units billed must be the actual number of tests dispensed, not the number of kits. For example, if two test kits are available per the package, then the quantity billed should reflect two.
  • There is a limit of 8 tests per member per rolling 30 days.
  • There will be no copay required for the test kits.
  • Pharmacies can back bill for members who purchased test kits starting 1/15/22.
To see the most recent list of covered NDC's, click here.

For an updated version of Kentucky Statewide Physician Protocol for Point of Care COVID-19 Testing, click here.

Contributors

Contributors

Upcoming Events