Dually Eligible Indicator of “GY” Modifier

The Florida Medicaid Management Information System (FMMIS) has recently been modified to incorporate changes regarding the Dually Eligible Modifier “GY”, utilized on home health services procedure codes.

As of Saturday, May 19, 2012, providers will no longer be required to submit the  “GY” modifier on each line item of a claim.  The changes to FMMIS will now allow the system to recognize when a recipient is dually eligible.

However, providers are asked to rebill any claims that were denied after April 20, 2012, for a prior authorization conflict or with an Explanation of Benefits (EOB) indicating that a procedure code/modifier conflict has occurred, without the GY modifier on the line level.

If you have any questions, please contact your local area Medicaid area office.

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