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Posting Date: 12/19/2016
Incident-to Services
Incident-to Services A physician, CP, CNS, NP, PA, or CNM may have outpatient psychiatric services and supplies furnished incident to his or her professional service. To be covered under the Incident to provision, the following requirements [...]
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Posting Date: 04/21/2021
Mental Health Services
Mental Health Services Table of Contents Psychiatric Diagnostic Procedures: 90791‒90792 Interactive Complexity: 90785 Psychotherapy: 90832‒90838 Psychotherapy for Crisis: 90839‒90840 Mobile Psychotherapy for Crisis Services: G0017-G0018 [...]
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Posting Date: 10/19/2023
Opioid Use Disorder Screening and Treatment: G0402, G0438, G0439, G2011, G0396, G0397
Opioid Use Disorder Screening and Treatment: G0402, G0438, G0439, G2011, G0396, G0397 Medicare coverage includes OUD screening when performed by physicians and NPPs. OUD screening must be performed as part of a Medicare beneficiary’s IPPE and [...]
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Posting Date: 04/21/2021
Related Content
Related Content CMS-1500 Claim Form Instructions CMS IOM Publication 100-02, Medicare Benefit Policy Manual CMS IOM Publication 100-04, Medicare Claims Processing Manual Chapter 1 - General Billing Requirements Chapter 12 - [...]
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Posting Date: 02/14/2019
Provider Revalidation Fact Sheet for Congressional Field Offices
Provider Revalidation Fact Sheet for Congressional Field Offices The Affordable Care Act, Section 6401 (a), requires enrolled providers to revalidate their Medicare enrollment every five years, and enrolled durable medical equipment suppliers [...]
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Posting Date: 03/19/2024
CMS Issues Change Request 13294 – Impacts Cost Reports with Disproportionate Share Hospital Reimbursement
CMS Issues Change Request 13294 – Impacts Cost Reports with Disproportionate Share Hospital Reimbursement CMS issued CR 13294,“Change Request (CR) to Implement the Medicare Program Final Action: Treatment of Medicare Part C Days in the [...]
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Posting Date: 03/26/2024
Discarded Drugs/Wastage and JW, JZ Modifier
Discarded Drugs/Wastage and JW, JZ Modifier Medicare may pay for discarded drugs or wasted drugs and biologicals when: The provider/supplier must discard the remainder of a single-dose container after administering a dose or quantity to a [...]
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Posting Date: 03/26/2024
Chemotherapy General Infusion Information
Chemotherapy General Infusion Information There are CPT codes for several different types of infusions and injections for drugs and biologicals. These include codes for chemotherapy infusions and injections, therapeutic, prophylactic and [...]
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Posting Date: 03/19/2024
Credit Balance Reminder: Submissions For Quarter Ending 3/31/2024 Start Soon!
Credit Balance Reminder: Submissions For Quarter Ending 3/31/2024 Start Soon! CBR submissions can be submitted starting on 4/1/2024 and are due within 30 days to be considered timely. Remember, even if no monies are owed to Medicare for this [...]
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Posting Date: 03/26/2024
Unlisted Codes for Drugs and Biologicals (J3490, J3590 and J9999)
Unlisted Codes for Drugs and Biologicals (J3490, J3590 and J9999) An unlisted code should only be used when no other code adequately describes the service. They are commonly used when the drug/biological does not have a specific HCPCS code, [...]
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