Q1: Are we looking at that correctly? Every private insurance company have set pay rates in place. Which means, they will only pay up to a certain amount. In this case, they $70 in therapy services, a day. Q2: Is that the end game for Medicaid requiring everyone to be credentialed with the health insurances? Medicaid has been paying for claims, but they must still be sent to private insurance and we must submit to Medicaid with the correct denial code. Not a rejection code. Q3: That would mean, Medicaid is the payor of last resort and requires us to bill private insurance which in turn has a blanket excusal that prohibits Medicaid from paying if the insurance pays anything (even under the current Medicaid rate)? Regardless of what pay rate private insurance has in place, we as providers must still submit all claims to them (PI) in order to get the denial code. maria.