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Jun 1, 2026

D-SNP member cost share reminder

D-SNP members have a member cost share on some services such as PCP visits (excluding annual physical), medical services related to X-rays, specialist visits, and Part B DME supplies. Any D-SNP member cost share should be billed to Medicaid. If you are not an approved Medicaid provider and are unable to submit your claim to Medicaid, you are not allowed to bill the member for the copay/coinsurance. 

Denial reason code according to your provider remittance advice: 

Denail reason