Revised nursing facility billing rate
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Notifies Medicaid nursing facility providers of revised facility billing rates effective October 1, 2024, explains how rates were calculated, where to access rate sheets, and how to appeal.
No material clinical or coverage changes in this revision.
Revised Rate Notification and Appeals
Revised rate notification and appeals
Operational instructions and recourse related to the revised billing rates.
Data Sources and Dates Used in Calculations
| No codes listed |
Provider Responsibilities and How to Appeal
Review revised rate sheet; report computation errors; access corrected Listing of Residents
Review the facility's revised billing rate sheet (emailed and posted on the Department website) and notify the Department of any billing rate computation errors. Access your corrected 'Listing of Residents' via the Web Portal or contact nhpassword@dch.ga.gov if you cannot download it; the Department and Myers and Stauffer will notify facilities when corrected listings are available for download.
- Billing rates are e-mailed to nursing facilities and posted at https://dch.georgia.gov/providers/provider-types/nursing-home-providers/reimbursement-rates.
- Notify the Department of any errors found on the billing rate computations; corrections and monetary adjustments will be implemented as appropriate.
- If you have not accessed the Web Portal to download your 'Listing of Residents,' contact the Office of Reimbursement at nhpassword@dch.ga.gov.
- You will receive an email from Myers and Stauffer when your corrected 'Listing of Residents' is available for download.
Submit appeals per Appendix I by November 4, 2024 to nh.appeals@dch.ga.gov
To appeal your facility's revised nursing home rate, follow the procedures in Appendix I of the Policies and Procedures for Nursing Facility Services manual and submit required documentation to DCH by November 4, 2024; late submissions will not be reconsidered.
- Submit appeal requests and supporting documents via email to nh.appeals@dch.ga.gov by November 4, 2024.
- If documentation is not received by November 4, 2024, DCH's calculation stands and will not be re-considered.
Key Terms Used in Rate Calculation
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