Indian Health Service (IHS)/638 Tribal Health

The manual is intended as a guide for providers who submit medical claims to Wyoming Medicaid. Providers must be familiar with all current rules and regulations governing the Wyoming Medicaid program.  Provider manuals are meant to assist providers with Medicaid billing; they do not contain all Medicaid rules and regulations. The provider manual is designed to answer most questions; however, questions may arise that require a call to a specific department such as provider relations.

When there is a change in the Medicaid program, Wyoming Medicaid will update the manual on a quarterly (January, April, July and October) and publish to this website.  Most changes come in the form of provider bulletins (via email) and remittance advice (RA) banners; others may be in newsletters or Wyoming Department of Health letters (via email) from state officials. It is critical for providers to keep their contact email address(es) up to date to ensure they receive all notices published by Wyoming Medicaid.

Reimbursement to IHS/638 Tribal facilities will be on an encounter basis and based on the approved all-inclusive rates published each year in the Federal Register by the U.S. Department of Health and Human Services.

Payment for multiple encounters on the same date of service will be allowed only if the services are categorically different and/or are provided for distinct and separate diagnoses. Different categories of allowable services shall include but are not limited to practitioner services, mental health services, optometry services, dental services, physical therapy, occupational therapy, and speech therapy. Any services provided outside of the clinic shall be reimbursed according to the Medicaid fee schedule.