You Asked, We Listened, We Delivered: Redesigned Events Page Live

You Asked, We Listened, We Delivered: Redesigned Events Page Live We’re always looking for and appreciate feedback from our providers. Your ideas and recommendations help drive improvements to our website. Providers suggested that we display [...]

Advance and Accelerated Payment Program Available for Providers Impacted by the Change Healthcare/Optum Payment Disruption

Advance and Accelerated Payment Program Available for Providers Impacted by the Change Healthcare/Optum Payment Disruption Part A and Part B Providers experiencing cash flow problems related to Change Healthcare/Optum Payment Disruption [...]

The Change Healthcare/Optum Payment Disruption (CHOPD) CMS Fact Sheet Now Available

The Change Healthcare/Optum Payment Disruption (CHOPD) CMS Fact Sheet Now Available CMS issued the Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated Payments to Part A Providers and Advance Payments to Part B Suppliers Fact Sheet [...]

Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated and Advance Payments for Part A Providers and Part B Suppliers

Proper Medicare Part B Claim Submissions – Completion and Regulation for the CMS-1500 Paper Claim Form Due to the Change Healthcare Security Incident

Proper Medicare Part B Claim Submissions – Completion and Regulation for the CMS-1500 Paper Claim Form Due to the Change Healthcare Security Incident Health care professionals and suppliers play a vital role in protecting the integrity of the [...]

Reminder: Medicare Part A Claim Submissions Due to the Change Healthcare Security Incident

Reminder: Medicare Part A Claim Submissions Due to the Change Healthcare Security Incident Medicare Part A providers can use the FISS DDE for Part A claim entry. This option is free, and the provider may already use FISS DDE. Note: FISS DDE [...]

MLN Connects® Newsletter: March 14, 2024

MLN Connects® Newsletter: March 14, 2024 News CMS Roundup (Mar 8, 2024) Marriage and Family Therapists & Mental Health Counselors: Updated Enrollment FAQs Skilled Nursing Facilities: Billing Medicare for Respiratory Vaccines [...]

Nonphysician Practitioners-Reducing Costly Appeals; Increase Provider Revenue

Nonphysician Practitioners-Reducing Costly Appeals; Increase Provider Revenue National Government Services is committed to reducing the provider burden associated with Medicare claim denials and appeals. A significant segment of denials and [...]

Ambulance Physician Certification Statement Guidelines

Ambulance Physician Certification Statement Guidelines Certification Type Certification Required? Yes/No Who May Sign the Certification Timeframe Other Information /Resources Nonemergency, scheduled, [...]

General Information

General Information Medicare Part B provides benefits for psychiatric services, which are medically necessary for the diagnosis or treatment of diagnostic and/or behavioral health treatment. Medicare recognizes the following Part B providers [...]

Provider Qualifications

Provider Qualifications Table of Contents Physicians - Psychiatrists Clinical Psychologist Independently Practicing Psychologist (IPP) Clinical Social Worker Marriage and Family Therapist (MFT) Mental Health Counselor (MHC) Physician [...]

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 [...]

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 [...]

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 [...]

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 - [...]

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 [...]

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 [...]

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 [...]

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 [...]