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Posting Date: 10/12/2022
Molecular Pathology: Claims Review and Supporting Information to Submit on the Claim
Molecular Pathology: Claims Review and Supporting Information to Submit on the Claim Table of Contents Molecular Pathology: Claims Review and Supporting Information to Submit on the Claim Prepayment and/or Post Payment Review Tier 2 Codes [...]
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Posting Date: 10/12/2022
Surgical Pathology Billing Tips
Surgical Pathology Billing Tips CPT Codes: 88300-88399 Surgical pathology is the study of tissues removed from living patients during surgery to help diagnose a disease and determine a treatment plan. Surgical pathology involves gross and [...]
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Posting Date: 10/13/2022
Pathology Interpretation Services
Pathology Interpretation Services National Government Services has noted that there is some confusion and questions regarding the billing of professional components on some laboratory services. There is a certain subset of CPT codes for which [...]
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Posting Date: 10/12/2022
Clarification on the Proper Reporting of Radiation Treatment CPT Code 77427
Clarification on the Proper Reporting of Radiation Treatment CPT Code 77427 National Government Services would like to advise providers that bill CPT code 77427, Radiation treatment management, five treatments, of the proper way to report this [...]
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Posting Date: 08/16/2022
Background/Overview
Background/Overview Effective for dates of service on and after 1/1/2020, CMS pays OTPs, through weekly bundled payments, to deliver OUD treatment services to Medicare beneficiaries. OTP is a Medicare Part B benefit that provides coverage for [...]
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Posting Date: 08/16/2022
How to Become a Medicare-Enrolled OTP Supplier
How to Become a Medicare-Enrolled OTP Supplier Table of Contents How to Become a Medicare-Enrolled OTP Supplier National Government Services Provider Enrollment Call Center NGS Provider Enrollment Mailing Address [Return to Top] How [...]
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Posting Date: 08/16/2022
Coding and Billing for OTP Services
Coding and Billing for OTP Services Table of Contents Coding and Billing for OTP Services Coding for OTP Weekly Bundles New for 2024 HCPCS Code G0137 Separate Add-on Codes Frequency of Use and Billing Billing Cycles [Return [...]
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Posting Date: 08/16/2022
Payment Rates
Payment Rates Medicare-enrolled OTPs are paid flat dollar payment rates for the codes describing the OTP bundled services (HCPCS codes G2067 through G2080, and G2215 to G2216). Payment rates are based on the OTP provider’s geographic location. [...]
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Posting Date: 08/16/2022
Claim Submission Instructions
Claim Submission Instructions Use the instructions on the Billing/Payment section of the CMS Opioid Treatment Program (OTP) web pages. Reviewed 9/3/2024
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Posting Date: 08/16/2022
Billing and Payment for Dual Eligible Beneficiaries
Billing and Payment for Dual Eligible Beneficiaries A person who is eligible for both Medicare and Medicaid at the same time is “dually eligible”. Medicare is the primary payer for OTP services delivered to dually eligible beneficiaries. [...]
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