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  • Posting Date: 11/19/2021
    Paper Enrollment Process

    Paper Enrollment Process Paper-based enrollment applications are available. Submitting your enrollment via paper is an option, but PECOS is the preferred method to process the application with streamlining features. Determine which CMS-855 [...]

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  • Posting Date: 04/29/2021
    Clinics/Group Practices and Other Suppliers

    Clinics/Group Practices and Other Suppliers Download CMS-855B. Complete Sections: 1, 2, 3, 4, 5, 6, 8, 12, 13, 15B and D (if applicable) Attachment 1 for Ambulance Suppliers Attachment 2 for IDTFs Attachment 3 for OTP Notes [...]

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  • Posting Date: 08/08/2023
    Introducing PECOS 2.0 

    Introducing PECOS 2.0 PECOS 2.0 will make the Medicare enrollment and revalidation processes faster and more efficient. For more information, visit Introducing PECOS 2.0. Revised 7/31/2024

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  • Posting Date: 08/28/2023
    Reviewing the PECOS Enrollment Practice Location Area for OPPS Providers Claim Submission

    Reviewing the PECOS Enrollment Practice Location Area for OPPS Providers Claim Submission All off-campus OPPS locations must be identified on the enrollment record. If a hospital OPPS claim is submitted with a practice service location that [...]

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  • Posting Date: 11/01/2021
    Transitional Care Management

    Transitional Care Management Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99495: Moderate complexity F2F 7 to 14 days 99496: High complexity F2F 7 days [...]

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  • Posting Date: 10/20/2021
    Advanced Care Planning

    Advanced Care Planning Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99497: 30 minutes 99498: each additional 30 minutes [Return to Top] Billing Information [...]

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  • Posting Date: 10/20/2021
    Behavioral Health Integration

    Behavioral Health Integration Table of Contents BHI Overview Eligible Conditions Part B Billing/Coding BHI Services New Coding and Payment for BHI Conditions Billed by Clinical Psychologists and Clinical Social Workers Initiating [...]

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  • Posting Date: 08/18/2022
    Chronic Care Management

    Chronic Care Management Table of Contents Billing Codes Billing and Documentation Care management for chronic conditions Related Content [Return to Top] Billing Codes 99490: Provide at least 20 minutes of clinical staff time [...]

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  • Posting Date: 01/19/2022
    Principal Care Management

    Principal Care Management Table of Contents Billing Codes Documentation Related Content [Return to Top] Billing Codes 99424: PCM services for a single high-risk disease first 30 minutes provided personally by a physician or [...]

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  • Posting Date: 10/07/2021
    Psychiatric Collaborative Care Model

    Psychiatric Collaborative Care Model The psychiatric CoCM was introduced in 2018 and Medicare began making separate payments using CPT codes 99492, 99493 and 99494. Effective 1/1/2021, G2214 was added to Psychiatric CoCM to cover shorter [...]

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