Skip to content
MedicaidRate
Start free trial
Sign inStart free trial

Wyoming Medicaid managed care: what plans must pay

Managed-care plans don't publish their provider fee schedules. What is public is the rule each plan must follow, set in Wyoming's plan contracts, statutes and notices. For 0 of 22 service lines, plans must follow a rule tied to the state's published rates.

Lines with a binding rule
0of 22
Plans on record
18
Directed payments
0amounts in the workspace
Capitation cells
2PMPM rates in the workspace

Who sets the rate, by service line

The main rule Wyoming's managed-care plans follow for each service line, in plain language.

Service lineMain rule for plansRatesAlso applies
Hospital outpatientNot classified yet29,118
Physician & professionalNot classified yet6,956
Hospital inpatientNot classified yet4,312
Equipment & suppliesNot classified yet2,806
Lab & pathologyNot classified yet1,377
PharmacyNot classified yet791
RadiologyNot classified yet665
DentalNot classified yet283
Behavioral healthNot classified yet125
HospiceNot classified yet121
Vision & hearingNot classified yet105
OtherNot classified yet105
Other home & community servicesNot classified yet68
Clinics (FQHC/RHC)Not classified yet54
Nursing facilityNot classified yet51
IDD servicesNot classified yet50
Therapy (PT/OT/speech)Not classified yet42
TransportationNot classified yet30
ABA / autism servicesNot classified yet22
Home healthNot classified yet16
Personal care & attendantNot classified yet14
Private duty nursingNot classified yet3
The plan rule on every Wyoming rate you bill. With the contract citation for each one.
Start free trial

Wyoming Medicaid managed-care plans

18 plans on record across 18 programs.

PACE (risk-based capitated; Laramie County) - ENDEDCheyenne Regional Medical Center PACE (Wyoming PACE)
Wyoming Care Management Entity (CME) - youth High Fidelity Wraparound; 1915(b) PAHP + CMHW 1915(c) (non-risk administrator)Magellan Healthcare, Inc. (Care Management Entity)
WYhealth care management / 24/7 nurse line (non-risk; no capitation; not a plan)WYhealth Health Management (WDH care management program)
Wyoming CHIP coverage group: Kid Care CHIP (FFS; no MCO)Wyoming Kid Care CHIP
Wyoming Medicaid coverage group: all Medicaid enrollees (FFS; no MCO)Wyoming Medicaid (all enrollees, FFS)
Coverage group (not a plan): ABD EIDWyoming Medicaid coverage group: ABD EID
Coverage group (not a plan): ABD ID/DD/ABIWyoming Medicaid coverage group: ABD ID/DD/ABI
Coverage group (not a plan): ABD InstitutionWyoming Medicaid coverage group: ABD Institution
Coverage group (not a plan): ABD Long-Term CareWyoming Medicaid coverage group: ABD Long-Term Care
Coverage group (not a plan): ABD SSI & SSI RelatedWyoming Medicaid coverage group: ABD SSI & SSI Related
Coverage group (not a plan): AdultsWyoming Medicaid coverage group: Adults
Coverage group (not a plan): ChildrenWyoming Medicaid coverage group: Children
Coverage group (not a plan): Children's Health Insurance Program (CHIP)Wyoming Medicaid coverage group: Children's Health Insurance Program (CHIP)
Coverage group (not a plan): Medicare Savings ProgramsWyoming Medicaid coverage group: Medicare Savings Programs
Coverage group (not a plan): Non-Citizens with Medical EmergenciesWyoming Medicaid coverage group: Non-Citizens with Medical Emergencies
Coverage group (not a plan): Pregnant WomenWyoming Medicaid coverage group: Pregnant Women
Coverage group (not a plan): Special GroupsWyoming Medicaid coverage group: Special Groups
Coverage group (not a plan): TotalWyoming Medicaid coverage group: Total

State-directed payments and capitation

Payments CMS approved under 42 CFR 438.6(c) that plans must make on top of, or as a minimum for, their negotiated rates, and 2 published capitation cells.

ProgramAmountUnitEffective
See Wyoming directed-payment amounts and capitation rates — start free

Every amount with its CMS approval letter or rate certification, effective dates and the providers it applies to.

Start free trial

Frequently asked questions

Do Wyoming Medicaid plans have to pay the state fee schedule?

The plan contracts we reviewed do not tie plan payment to the state's rates for most lines; plans negotiate rates with providers.

Where do these rules come from?

From Wyoming's managed-care plan contracts, state statutes and regulations, provider notices and CMS-approved directed-payment filings. Each rate in the workspace carries its citation.

Can I see what each plan actually pays?

No plan publishes its provider fee schedule. The closest public signals are the binding rules above, state-set rates, directed payments and the state's own payment-level estimates in its directed-payment filings.

More on Wyoming

Wyoming

Wyoming Medicaid fee scheduleRates by code, industry and serviceWyoming ABA ratesWyoming Behavioral health ratesWyoming Home care ratesWyoming Private duty nursing ratesWyoming Skilled nursing ratesWyoming Hospice ratesWyoming IDD / waiver ratesWyoming Therapy rates

Managed care in nearby states

Arizona managed careColorado managed careIdaho managed careMontana managed careNevada managed careNew Mexico managed care

← All Wyoming Medicaid rates