Current medicaid hrly rate for lpn pvt duty nursing in queens, ny

U.S.A. New York

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Does anybody know how much can an LPN get for home care as a participating provider in the New York Medicaid Program in the county of Queens? I have been calling Medicaid offices in all five boroughs of NYC and nobody answers the phone, only answering machines ... have left messages but nobody calls me back ... anybody can solve this "mistery"?

Thank you! :nurse:

This is my first reply ever to AllNurses.com...so lets hope I get it right.

I graduate in May as an RN from a 4 year program. I was looking to get a Medicaid Provider number so that I am able to get a couple of Private Duty cases in Pediatrics after I graduate.

I am a little confused because on the Emedny site it stated that you cannot get a provider number if you work in a providers office or a hospital? So you cannot hold a "second job" in the state of New York? Is someone able to clarify this for me? And also...does anyone know what the fee schedule is for RN Private duty cases?

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this is my first reply ever to allnurses.com...so lets hope i get it right.

i graduate in may as an rn from a 4 year program. i was looking to get a medicaid provider number so that i am able to get a couple of private duty cases in pediatrics after i graduate.

i am a little confused because on the emedny site it stated that you cannot get a provider number if you work in a providers office or a hospital? so you cannot hold a "second job" in the state of new york? is someone able to clarify this for me? and also...does anyone know what the fee schedule is for rn private duty cases?

they are referring to you not being able to use a medicaid provider number for other than homecare. you can't work in a provider's office or hospital & get reimbursed thru medicaid. it's only for homecare.

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At my agency they bill medicaid 34 per hour for an Lpn, I'm not sure if it's based on DX or not. I've seen adds for $37 starting lpn on L.I. I am awaiting my medicaid provider # then off to private duty!!! Good Luck!!

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What additional education are they wanting you to have as an LPN to earn the additional 30% an hour???

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Also do you do your own billing? Any pointers?? I truely appreciate any assistnace you could provide!!!

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What additional education are they wanting you to have as an LPN to earn the additional 30% an hour???

You have to fill out a form with the experience you have working with medically fragile children. the form is available on emedny website - you can call customer service to navigate your way around the site to find that specific form - (it would take me forever to figure it out again & then write the directions in where it is on the website , sorry) Interestingly, my friend who ONLY had 1 case out of LPN school did NOT have to do this - she was Grandfathered in - so I don't know how strict it is or if anyone is denied.

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Also do you do your own billing? Any pointers?? I truely appreciate any assistnace you could provide!!!

YES! you do your own billing directly on the emedny website - WARNING - it's a pain in the butt to figure out - speak with other nurses on your case (for codes & numbers, tips, etc.)& customer service at emedny (hint - some are more helpful than others - don't be afraid to call right back again with the same question hoping to get a better customer service rep - they run the gamut from poor to awesome) you'll need a variety of numbers & things - once you finally figure it out & have all of your numbers that you need (if you're like me you would have called about 50X - always being super-polite) until you are finally able to wing thru each time in a few minutes. You'll always need a "cheat sheet" with all of the numbers you need everytime you submit a claim: passwords, zipcodes, authorization code, LPN homecare code, pt id number, & a few other things. Good luck all!!!!!!! (also this can be done on paper as well with claim forms which you will receive - but I think the electronic billing would be much much easier once you have it down pat.) Lisa (ps - don't forget to take out all of your taxes with each paycheck so you have the money to pay your taxes at tax time!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!)

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You have to fill out a form with the experience you have working with medically fragile children. the form is available on emedny website - you can call customer service to navigate your way around the site to find that specific form - (it would take me forever to figure it out again & then write the directions in where it is on the website , sorry) Interestingly, my friend who ONLY had 1 case out of LPN school did NOT have to do this - she was Grandfathered in - so I don't know how strict it is or if anyone is denied.

Hi - i'm adding to my own post because I thought it was inadequte - you must be thinking - but I don't have any experience with medically fragile children - well, I'm no expert - I don't know exactly which requests they deny or accept - but if you have ANY experience with medically fragile children obviously put that down, maybe after that put down ANY experience you have working as a nurse or nurses aid & any additional education. You could try putting your experiences in LPN school. I was lucky in that I took care of a girl w/CP - but other than that I put my additional (uncompleted) RN education & experience working as a nurses aid in a nursing home. Good luck all!!!!!!!!!!

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Thank you, Thank you, Thank you!!! I knew all nurses didn't eat there young lol!! I appreciate all of the pointers!!!!

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Hi - i'm adding to my own post because I thought it was inadequte - you must be thinking - but I don't have any experience with medically fragile children - well, I'm no expert - I don't know exactly which requests they deny or accept - but if you have ANY experience with medically fragile children obviously put that down, maybe after that put down ANY experience you have working as a nurse or nurses aid & any additional education. You could try putting your experiences in LPN school. I was lucky in that I took care of a girl w/CP - but other than that I put my additional (uncompleted) RN education & experience working as a nurses aid in a nursing home. Good luck all!!!!!!!!!!

My 3rd answer on the question re how to get approved for the 30% for medically fragile children - I forgot to mention the obvious - simply take a case & get the original pay - THEN when you have experience (there's NO question on length of time for experience) apply for the 30% increase so you have something to write - example - gave meds via G-tube, administered insulin, trach care....(all things you may do with a child considered medically fragile) Good luck!

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Sorry to bother you again, I was wondering besides progress notes & MAR what other documentation you are keeping on your patient. I dont want to screw up!!! Also, Are there procedure codes for each thing we do as a home care nurse, or is it just one procedure code for private duty nursing? Thank you again!!

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Sorry to bother you again, I was wondering besides progress notes & MAR what other documentation you are keeping on your patient. I dont want to screw up!!! Also, Are there procedure codes for each thing we do as a home care nurse, or is it just one procedure code for private duty nursing? Thank you again!!

Well, I've only had 2 cases with Medicaid (not counting agency cases). & in my 2 cases - yes - 1 procedure code for LPN homecare. Sometimes you need dx codes - but you just ask the family or other nurses on the case. With one of my pt's there was a lot of documentation - she needed a lot of care. With my second pt there is considerably less. & to be honest - with taking care of children - at least in my experience - the PARENTS are the best teachers - they know what their kids need. Obviously you ARE on your own - so don't do anything to compromise your license.

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