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Physician Billing Guidelines - eMedNY

Physician Billing Guidelines - eMedNY 2025

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The document outlines the New York State Medicaid billing guidelines for physicians, detailing the claims submission process for both electronic and paper formats. It emphasizes the use of the eMedNY system for submitting claims and provides specific instructions for completing the eMedNY-150003 claim form. Key sections include requirements for billing physician services, remittance advice details, and appendices with claim samples. The purpose is to ensure compliance with Medicaid's specific requirements and facilitate accurate claims processing.

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Click ‘Get Form’ to open the Physician Billing Guidelines - eMedNY in the editor.
Begin by reviewing the Purpose Statement on page 4, which outlines the specific requirements for billing Medicaid services.
Navigate to the Claims Submission section. Here, you can choose between electronic claims using HIPAA 837P or paper claims using the eMedNY-150003 claim form.
If submitting electronically, ensure you have all necessary information as outlined in the guidelines. For paper submissions, carefully fill out each field of the eMedNY-150003 form, paying special attention to fields like Sterilization/Abortion Code (Field 22D) and Family Planning (Field 22H).
Refer to Appendix A for claim samples that illustrate how to complete your form accurately.
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