PDF Version

TO:  Nursing Home Providers

Per Diem Rate Change for COVID-19 Emergency

Effective for claims with Medicaid patient dates of service 3/1/2020 through the end of the national emergency, there will be a $20.00 add on to the per diem payment for all Nursing Facilities due to the COVID-19 state of emergency. This payment will be added automatically. The add on payment for Claims submitted with and prior to the April 17, 2020 checkwrite cutoff will be included in the disbursement on 4/27/2020. If claims for dates of service for the affected period have already been submitted, they will be reprocessed with no action required on your part.

Cleaning Fee Reimbursement

There will also be an incremental payment for cleaning fee reimbursement for costs incurred for facilities with COVID-19 residents or staff.

For cleaning fee reimbursement the following documentation is required:

·       Invoice for Cleaning Services showing square footage of facility (Reimbursement will

       not exceed $1.50 per square foot)

·        Documentation of confirmed COVID-19 positive resident or staff by the CDC or ADPH

·      Recommendation/Guidance from CDC or ADPH regarding cleaning and sanitizing

  requirements and certification by Nursing Home, CDC, or ADPH that such guidance

  was followed

Please note this is a one-time payment regardless of the number of instances the facility is required to be cleaned. In the case of multiple use facilities, such as hospital-nursing facility or retirement home-nursing facility, only the cost for cleaning the nursing facility and not the assisted living, independent living, hospital or rehabilitation gym will be reimbursed. The Medicaid days reported on the June 30, 2019, cost report will be used to determine the Medicaid allowable percentage amount reimbursed.

Send documentation to Demetrius Bass at Demetrius.Bass@medicaid.alabama.gov.

Payment will be made on the next reasonable checkwrite after receiving documentation and approval.

During the COVID-19 emergency, it is important to file claims as quickly as possible to ensure payment from Medicaid is made to Medicaid providers close to the date of service. The Centers for Medicare and Medicaid Services (CMS) has increased the federal matching percentage for the emergency time frame, but states can only receive the increased match on claims that are paid during the emergency. 

The Current Procedural Terminology (CPT) and Current Dental Terminology (CDT) codes descriptors, and other data are copyright © 2020 American Medical Association  and © 2020 American Dental Association (or such other date publication of CPT and CDT). All rights reserved. Applicable FARS/DFARS apply.