NY Medicaid Updates Physician and Dental Procedure Codes & Manual

In the winding days of 2012, the New York State Medicaid announced billing code changes for physicians and nurse practitioners as well as billing code changes and changes to the policy manual for New York dentists participating in the Medicaid program. We discuss some of those changes in this article.

Physicians and Nurse Practitioners

The New York State Medicaid has discontinued certain codes and instituted new ones relating to drugs, radiology, surgery, and medicine for physicians. This change effects all services rendered on or after 1/1/2013.

The list of discontinued and new codes can be located here although providers should regularly refer to the physician fee schedule for any updates and changes.

Changes were likewise made to certain procedure codes related to drugs, medicine and surgery billed by nurse practitioners. The changes go into effect for services rendered on or after 1/1/2013 and can be located here and an updated fee schedule can be located here.


Dentists should be aware that certain procedure codes have been removed effective 1/2/2013 (e.g., D0360, D6970, etc). Likewise, dentists should be aware of the addition of new codes, such as T1013, which is the reimbursement code for sign language and oral interpretive services. The NY Medicaid has also released an updated version of the Dental Policy and Procedure Manual (Manual). The last time the Manual was updated was in October 2012. While a summary of those changes is provided by NY Medicaid, dentists must refer to the newly amended 2013 Manual, as well as the 2013 Fee Schedule for more information and details concerning the changes.

If you have a question about the New York State Medicaid Program, provider enrollment, revalidation or participation or have other legal questions, please contact us here.