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New York State FeeForService Medicaid Program
Renewal Request for OutofState Skilled Nursing FacilityProvide this completed form with any new prior approval requests entered into spaces.
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What is new york state fee-for-service?
New York State fee-for-service is a payment model in which providers are reimbursed based on the number of services they provide.
Who is required to file new york state fee-for-service?
Healthcare providers who offer services covered by Medicaid in the state of New York are required to file fee-for-service claims.
How to fill out new york state fee-for-service?
Providers can fill out the fee-for-service claims online through the Medicaid Management Information System (MMIS) or by submitting paper claims.
What is the purpose of new york state fee-for-service?
The purpose of New York State fee-for-service is to ensure that healthcare providers are reimbursed for the services they provide to Medicaid beneficiaries.
What information must be reported on new york state fee-for-service?
Providers must report the services provided, the dates of service, the diagnoses, and any procedure codes on the fee-for-service claims.
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