Medicaid Fee-for-Service Eligibility

Fee-for-service, or traditional, Medicaid is for people who are not enrolled in managed care. Pharmacies must submit claims with the values identified below. Refer to the Claims Billing (B1) Transaction for instructions and payer sheets.

Pharmacies should not submit claims for newborns without an assigned Medicaid ID number with their Mother’s ID number. Pharmacies must submit these claims on the Pharmacy Claims Billing Request.