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Provider Information and Forms
Provider Information and Forms
DC APR-DRG FAQ Eff 10/1/2020 DCI20030
DC APR-DRG Pricing Calculator Eff 10/1/2020 DCI20031
DC EAPG Never Pay List Eff 10/1/2020 DCO20035
2020 Fee Schedule Update Detail
Prescription Order Form (POF)
DC EAPG Never Pay List Eff 10/1/2019 DCO19018
DC EAPG Grouper Settings Eff 10/1/2019 DCO19019
DC EAPG Relative Weights Eff 10/1/2019 DCO19021
DC EAPG IP Only List Eff 10/1/2019 DCO19020
CMS Approves DHCF 1915c HCBS Waiver Appendix K Emergency Preparedness Response Plan
DC Medicaid Coding for Telemedicine and Coronavirus (COVID-19)
ICD-10-CM Official Coding Guidelines Coding encounters related to COVID-19 Coronavirus Outbreak
DC 2017 Fee Schedule Pricing Update Eff 1/1/2017
TPL Payments
DC EAPG Information on EAPGs Eff 10/1/2019 DCO19006
DC EAPG FAQ Eff 10/1/2019 DCO19004
DC Specialty Hosp DRG Pricing Calculator Eff 10-1-2019 DCS19014
HPV Vaccine Reminder
DC Nursing Facility Cost Report Instructions
DC EAPG Never Pay List Eff 01/01/2018 DCO17059
Conduent EDI Gateway Pharmacy Registration
Compiled Behavioral Health Transformation Demonstration Program Rates
Crossover Pricing Logic
ASC Fee Schedule (Excel)
Consent For Sterilization - English - HHS 687
DC Specialty Hosp FAQ Eff 10/1/2020 DCS20016
DC EAPG Information on EAPGs Eff 10/1/2020 DCO20029
Managed Care Provider FAQs
DC Specialty Hosp DRG Pricing Calculator Eff 10-1-2020 DCS20015
DC APR-DRG FAQ Eff 10/1/2018 DCI18004
DC EAPG Never Pay List Eff 10/1/2018 DCO18021
DC Medicaid Beneficiary Disclosure and Commitment to Take Hepatitis C Medications
Conflict-Free Case Management Self-Attestation Form
DC EAPG Grouper Settings Eff 10/1/2018 DCO18022
DC EAPG FAQ Eff 10/1/2018 DCO18005
DC EAPG Information on EAPGs Eff 10/1/2018 DCO18006
DC Specialty Hosp FAQ Eff 10/1/2018 DCS18006
DC Specialty Hosp DRG Pricing Calculator Eff 10-1-2018 DCS18028
ICD-10 Emergency Codes Listing - October 2020
FQHC Quick Reference Guide
DC EAPG Grouper Settings Eff 10/1/2020 DCO20031
FQHCs Payment Methodology Frequently Asked Questions
DC EAPG Relative Weights Eff 10/1/2020 DCO20032
DC EAPG IP Only List Eff 10/1/2020 DCO20033
Conduent EDI Provider Enrollment Form
Provider Conduent EDI Gateway Authorization Form for Billing Agents and Clearinghouses
Hospice Election and Physician Certification
Revised Behavioral Health Transformation Demonstration Program Rates
DC APR-DRG Pricing Calculator Eff 10/1/2018 DCI18018
DC EAPG Relative Weights Eff 10/1/2018 DCO18023
DC EAPG IP Only List Eff 10/1/2018 DCO18024
DC EAPG FAQ Eff 10/1/2020 DCO20028
719A Prior Authorization Request Form
DC Nursing Facility Cost Report Form
DC Specialty Hosp FAQ Eff 10/1/2019 DCS19004
DC APR-DRG FAQ Eff 10/1/2019 DCI19005
Consent For Sterilization - Spanish - HHS 687-1
Hospice Discharge Form
Level 1 Pre-Admission Screen/Resident Review (PASRR) for SMI, ID, or Related Conditions
DC Alliance Formulary List
DC APR-DRG Pricing Calculator Eff 10/1/2019 DCI19016
EFT Application
DC EAPG Never Pay List Eff 01/01/2021 DCO21001