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Posting Date: 12/18/2024
Provider Enrollment Application Fee Amount for CY 2025
Provider Enrollment Application Fee Amount for CY 2025 The provider enrollment application fee for CY 2025 is $730. For more information, view MLN Connects® Newsletter: December 12, 2024. Posted 12/18/2024
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Posting Date: 03/21/2024
Medicare Part B Drug Coverage
Medicare Part B Drug Coverage Medicare Part B may provide coverage for medically necessary drugs/biologicals that are furnished “incident to” a physician’s service. This coverage does not apply to drugs that are usually [...]
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Posting Date: 03/21/2024
Allergen Immunotherapy: Coding and Billing CPT 95165
Allergen Immunotherapy: Coding and Billing CPT 95165 CPT 95165 is defined as “Professional services for the supervision of preparation and provision of antigens for allergen immunotherapy; single or multiple antigens (specify number of [...]
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Posting Date: 12/18/2024
Home Health Claims Returning to Provider RC 19963
HH claims are returning to provider in error with RC 19963. This impacts HH claims with NOA/processed dates in January 2022. NOAs are being purged after 24 months. Please keep in mind there are claims that edit correctly for this reason code. [...]
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Posting Date: 12/18/2024
[REVISED UPDATE] Hospice Claims Rejected with Reason Code 17729
Claim rejections for TOB 081X and 082X with RC 17729 have occurred due to a file error. These claims did comply with CMS-required entry of the correct certifying physician in the “Attending” field, which did match the PECOS Enrolled [...]
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Posting Date: 06/09/2021
About Hospital OPD PA Model
About Hospital OPD PA Model Table of Contents About Hospital OPD PA Model General Information Related Content [Return to Top] About the Hospital OPD PA Model CMS implemented a PA program for certain hospital OPD services for DOS on [...]
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Posting Date: 06/14/2022
Documentation Information
Documentation Information It is recommended that PARs are submitted at least ten business days prior to the expected date of service to allow National Government Services the full standard timeframe to receive and review requests. Effective [...]
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Posting Date: 06/09/2021
Expedited Requests
Expedited Requests The requester may submit for an expedited review of the PAR if it is determined that a delay could seriously jeopardize the beneficiary’s life, health, or ability to regain maximum function. If the medical documentation does [...]
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Posting Date: 12/19/2024
Reminder for Correcting Hospice Edits for Certifying Physicians (17729, 17730)
Reminder for Correcting Hospice Edits for Certifying Physicians (17729, 17730) Reason Codes 17729 and 17730: Refer to specific hospice claim edits related to certifying physicians. Adjustments: Should be submitted for correcting input [...]
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Posting Date: 12/19/2024
MLN Connects® Newsletter: December 19, 2024
MLN Connects® Newsletter: December 19, 2024 News MBI Lookup Tools: CMS Seeks Input by February 17 CMS Roundup (December 13, 2024) Long-Term Care Hospital Provider Preview Reports: Review by January 15 Inpatient Rehabilitation Facility [...]
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