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Posting Date: 04/11/2024
MLN Connects® Newsletter: April 11, 2024
MLN Connects® Newsletter: April 11, 2024 Proposed Payment Rules CMS Proposes New Policies to Support Underserved Communities, Ease Drug Shortages, and Promote Patient Safety News CMS Roundup (Apr. 5, 2024) Medicare Shared Savings [...]
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Posting Date: 04/15/2024
NGSConnex Medicare Part B Remittances
NGSConnex Medicare Part B Remittances We’ve added an enhancement that offers providers the option to view/print remittance advices in NGSConnex for up to 24 months from the date of search. You are required to complete the EDI enrollment to [...]
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Posting Date: 04/15/2024
Social Security Income Ratios
Social Security Income Ratios The federal fiscal year 2022 SSI ratios for IPPS hospitals, IRFs and LTCHs were posted on the CMS website. IPPS IRF LTCH We will update the latest published 2022 SSI ratios in the Provider Specific File of [...]
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Posting Date: 04/16/2024
Reimbursing Place of Service 10 at the Nonfacility Rate for Medicare Telehealth Services
In CY 2024, CMS issued a change to processing for telehealth services billed with POS 10. As of 1/1/2024, these claims are to be paid at the nonfacility PFS rate. A system processing issue resulted in incorrect payments at the facility rate and [...]
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Posting Date: 02/02/2021
Submit Supporting Documentation
Submit Supporting Documentation We encourage you to submit cost reports and supporting documentation electronically whenever possible. In addition to the environmental benefits of this approach, it is also more time and cost efficient. The [...]
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Posting Date: 04/17/2024
Part B Top Claim Errors Updated
Part B Top Claim Errors Updated Using data analysis we update the Top Claim Errors on a quarterly basis and provide: the error reason code; a description of the error; the error type; details that include steps you can take to [...]
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Posting Date: 12/14/2018
Hospice Pricer Tool
Hospice Pricer Tool The CMS Web Pricer will assist in evaluating your hospice claim reimbursement. Revised 4/18/2024
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Posting Date: 04/18/2024
MLN Connects® Newsletter: April 18, 2024
MLN Connects® Newsletter: April 18, 2024 News PrEP for HIV: Prepare for Potential Medicare Part B Coverage Events Clinical Laboratory Fee Schedule Upcoming Meetings: Register to Present, Speak, or Attend in Person by June 1 [...]
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Posting Date: 06/26/2023
Helpful Reminders on Advance Care Planning
Helpful Reminders on Advance Care Planning ACP billing codes: 99497: Advance care planning, including the first 30 minutes of face-to-face explanation and discussion (when performed) of advance directives such as standard forms. 99498: [...]
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Posting Date: 04/19/2024
Reminders for the New Hospice Certifying Physician Claim Edit Effective 5/1/2024
Reminders for the New Hospice Certifying Physician Claim Edit Effective 5/1/2024 Effective for hospice claim "From" dates on or after 5/1/2024, CMS implemented edits to enforce a new rule that would deny hospice claims if the certifying [...]
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Posting Date: 04/22/2024
Top Claim Errors Have Been Reviewed and Updated
Top Claim Errors Have Been Reviewed and Updated Our top claim errors are updated on a quarterly basis to reflect current information. Visit Top Claim Errors under Resources > Claims and Appeals to learn what you can do to avoid claim [...]
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Posting Date: 04/23/2024
Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex
Table of Contents Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex What are the benefits? [Return to Top] Receive and Respond to Audit and Reimbursement Correspondence via NGSConnex National Government [...]
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Posting Date: 04/24/2024
Home Office Cost Statements
A home office of a chain organization is a related organization to its participating providers. Home offices usually furnish central management and administrative services, e.g., centralized accounting, purchasing, personnel services, [...]
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Posting Date: 04/25/2024
MLN Connects® Newsletter: April 25, 2024 (UPDATE)
MLN Connects® Newsletter: April 25, 2024 (UPDATE) Editor's Note: CMS updated a message because we delayed the effective date that physicians who certify hospice services must enroll in or opt-out of Medicare until 6/3/2024. You may have to [...]
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Posting Date: 04/29/2024
LCD and Article Updates for April/May 2024
LCD and Article Updates for April/May 2024 Billing and Coding Articles Billing and Coding: Allogeneic Hematopoietic Cell Transplantation for Primary Refractory or Relapsed Hodgkin and Non-Hodgkin Lymphoma with B-cell or T-cell Origin (A59311) [...]
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Posting Date: 04/29/2024
Billing for Drug Wastage: JW and JZ Modifier
Billing for Drug Wastage: JW and JZ Modifier Properly billing for drug wastage and associated modifiers helps to prevent claims processing errors and denials while ensuring you receive correct reimbursement. Providers and suppliers are to [...]
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Posting Date: 04/29/2024
National Government Services Proposed LCDs for Comment (4/25/2024-6/8/2024)
National Government Services Proposed LCDs for Comment (4/25/2024-6/8/2024) The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends from 4/25/2024 through [...]
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Posting Date: 04/29/2024
What Are the Recovery Auditors' Responsibilities_Part A-B-FQHC-HHH
What Are the Recovery Auditors' Responsibilities? What Are the Recovery Auditors' Responsibilities? Recovery Auditors review claims on a postpayment basis using the same Medicare policies as MACs: NCDs LCDs and CMS manuals/regulations To ensure [...]
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Posting Date: 04/29/2024
How Will I Know When a Payment Determination Has Been Issued_Part A-B-FQHC-HHH
How Will I Know When a Payment Determination Has Been Issued? How Will I Know When a Payment Determination Has Been Issued? When a Recovery Auditor finds that improper payments have been made, they will submit claim adjustments to your MAC. The [...]
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Posting Date: 04/29/2024
ALOB_What Are My Options When I Receive the Recovery Auditor Demand Letter
What Are My Options When I Receive the Recovery Auditor Demand Letter? What Are My Options When I Receive the Recovery Auditor Demand Letter? If you agree with the Recovery Auditor’s determination you can: repay the overpayment amount by check; [...]
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