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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. (Not for
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New York State fee-for-service is a payment model in which providers are reimbursed based on the number of services they provide.
Healthcare providers who offer services covered by Medicaid in the state of New York are required to file fee-for-service claims.
Providers can fill out the fee-for-service claims online through the Medicaid Management Information System (MMIS) or by submitting paper claims.
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.
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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