In order to qualify for the enhanced rates, eligible enrolled Nebraska Medicaid providers must attest to being a primary care physician by one of the following:
- Board certification as a primary care physician by the American Board of Medical Specialties (ABMS), the American Board of Physician Specialties (ABPS), or the American Osteopathic Association (AOA) or
- Have furnished evaluation & management (E&M) and vaccines services (codes specified by federal regulation) that equal at least 60% of the Medicaid codes billed during the most recently completed fiscal year.
Eligible providers who may qualify for the enhanced rate must complete an Attestation Form to be submitted with the identified documentation to the Medicaid central office. Providers must attest for each new provider number or any time the provider's status of eligibility changes.
Attestation Form
Providers should send forms and documentation to the following address:
DHHS Medicaid and Long-Term Care
Enhanced PCP Rates
P.O. Box 95026
Lincoln, NE 68509-5026
Or Fax to: (402) 471-9092 Attention: Enhanced PCP Rates
To assist in delivery of information, a dedicated email address has been created for questions and answers specific to this program change. We will gather the questions and responses and place them on our website. The email address is: DHHS.EnhancedPCPRates@nebraska.gov.