H2027 and H0038 Notification

Please note that effective January 1, 2025, the Kentucky Department for Medicaid Services’ (DMS) policy regarding peer support and psychoeducation will be effective. Providers were notified of this policy by DMS on November 1, 2024.

• Psychoeducation Policy Update: H2027 and H0038 11.1.24 (PDF)

WellCare providers who receive claim denials above the stated limits within the policy will need to appeal to demonstrate medical necessity. Instructions for appeals can be found within the WellCare Quick Reference Guide or within the Explanation of Payment (EOP).