MedicaidAdministrativeMedium impact
School-Based Medicaid Program – Guidance to Resolve 047 Claims Denials
Louisiana Medicaid·LA · Occupational Therapy·Specialty Services
We identified it
Jun 18, 2026
Summary
Louisiana Medicaid issued guidance to resolve 047 claim denials for School-Based Medicaid Program claims caused by missing or incorrect ordering/prescribing/referring provider information. LEA providers, including audiologists and occupational therapists, must now enroll as provider type PO-OPR and use specific taxonomy codes as tiebreakers when submitting claims.
Action Required
Immediately: LEA providers (audiologists, occupational therapists, and other licensed professionals) must enroll in Louisiana Medicaid as provider type PO-OPR using the enrollment packet. Obtain NPI tiebreaker taxonomy code 251300000X for SBMP claims. Complete and submit the SBMP - NPI Tiebreaker Form by fax to (225) 216-6392 or email to louisianaprovenroll@gainwelltechnologies.com. Update billing system to include correct OPR NPI and taxonomy codes on all SBMP claims. Claims will continue to be denied with error code 047 without proper OPR information.