Frequently Asked Questions for the Private Duty Nursing Directory
The Private Duty Nurse Medically Fragile Directory´s purpose is to promote the availability and ensure delivery of fee-for-service private duty nursing services to medically fragile children and individuals transitioning out of this category of care up to the age 23.
Who is eligible to enroll to be in the Directory?
Fee-for-service (FFS) private duty nurses. Both independent nurses and nursing agencies.
When does it start?
Provider enrollment applications will be accepted starting in September 2020. October 1, 2020 the directory and the enhanced fees will be available.
What is required to be in the directory?
Qualified providers enrolling in the directory shall ensure the availability and delivery of such services to individuals in need of private duty nursing services.
Where will the directory be located?
Who will use the directory?
Those seeking FFS private duty nursing services for medically fragile individuals up to the age 23.
How do private duty nurses enroll?
– The enrollment application will be available on eMedNY with the other Private Duty Nurse Medicaid enrollment applications. The application form will contain both the Medically Fragile Children Training and Experience and the Medically Fragile Children Directory programs.
What are the fee enhancements?
15% starting 10/1/2020, 30% starting 4/1/2021 and 45% starting 4/1/2022. Percentages will apply to the base fee based on region and licensure.
Are there other changes to the fee structure?
The county base fees will transition to regional fees (upstate and downstate) effective October 1, 2020.
Where will the regional base fees be located?
The fee schedule is available here.
Are nurses eligible for the Medically Fragile Children
Training and Experience fee enhancement and the
Medically Fragile Children Directory?
Yes. The 30% fee enhancement is available to enrolled providers for the Medically Fragile Children Training and Experience fee enhancement became available up to age 23 on October 1, 2020.
Will there be more information available?
Yes, additional information will be available on eMedNY and the NYS Department of Health website. Please subscribe to the eMedNY Private Duty Nursing LISTSERV
Questions?
For provider enrollment questions contact the eMedNY Call Center at 800-343-9000. For FFS prior approval questions contact the OHIP Call Center at 800-342-5000.
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