Correct Coding Reminder for Breast Imaging

Correct Coding Reminder for Breast Imaging When there are no abnormal and inconclusive findings on mammography and the only finding is dense breast tissue (ICD-10-CM codes R92.30-R92.34), the provision of an ultrasound is considered screening. [...]

MLN Connects® Newsletter: January 4, 2024

MLN Connects® Newsletter: January 4, 2024 News CMS Roundup (Dec 29, 2023) In-Home Vaccine Administration: Additional Payment Organizational Providers: Do You Need to Revalidate Your Enrollment Record Soon? Value-Based Insurance Design [...]

340B Drug Payment Policy Remedy Payment for CY 2018 to CY 2022

340B Drug Payment Policy Remedy Payment for CY 2018 to CY 2022 On 6/15/2022, the Supreme Court held in American Hospital Association v. Becerra that because CMS had not conducted a survey of hospitals’ acquisition costs, it could not vary the [...]

30-Day Home Health Therapy Reassessment Schedule

Intensive Outpatient Program

Medical Review

Education Partnership Request Form

Chimeric Antigen Receptor (CAR) T-cell Therapy

MLN Connects® Newsletter: January 11, 2024

MLN Connects® Newsletter: January 11, 2024 News Marriage and Family Therapist & Mental Health Counselor Services: Overpayments to Critical Access Hospitals Billing under Method II Medicare Part A Cost Report Exhibits: New Electronic [...]

MLN Matters® MM13331: Incorporation of Recent Provider Enrollment Regulatory Changes into Chapter 10 of CMS Publication (Pub.) 100-08 - Physician Fee Schedule (PFS) Final Rule

MLN Matters® MM13331 - Incorporation of Recent Provider Enrollment Regulatory Changes into Chapter 10 of CMS Publication (Pub.) 100-08 - Physician Fee Schedule (PFS) Final Rule Revised 1/12/2024

Low and No Medicare Utilization Cost Report

Low and No Medicare Utilization Cost Report No Utilization Cost Reports To comply with program cost reporting requirements, a provider that has not furnished any covered Medicare services during a cost reporting period must only complete the [...]

MLN Connects® Newsletter: January 18, 2024

MLN Connects® Newsletter: January 18, 2024 News CMS Finalizes Rule to Expand Access to Health Information and Improve the Prior Authorization Process Acute Hospital Care at Home Data Release CMS Roundup (Jan 12, 2024) Medicare Part B [...]

Medicare Requirements for Marriage and Family Therapists and Mental Health Counselors

Medicare Requirements for Marriage and Family Therapists and Mental Health Counselors Effective 1/1/2024, Medicare added two new nonphysician specialties. To enroll with Medicare, all the requirements for the specialty must be met. [...]

Teaching Physician Virtual Supervision in 2024 Clarification

Teaching Physician Virtual Supervision in 2024 Clarification This article is to clarify virtual supervision provided by the teaching physician for the key portions of the service of a resident. There has been some confusion on the setting in [...]

12/14/2023 Part B POE Advisory Group Meeting

12/14/2023 Part B POE Advisory Group Meeting Meeting Minutes Meeting Time: 10:00 a.m.‒12:00 p.m. ET Member Attendees: Jennifer Asencio, Doris Barnes, Aurelio Barraco, Madelon Berger, Joanna Bielak, Brenda Bedard, Sheila Bembenek, Madelon [...]

Revised: Interactive Voice Response System Feature Ending Soon

Revised: Interactive Voice Response System Feature Ending Soon It was announced on 1/10/2024 that the following function will no longer be available on our IVR System as of 2/16/2024. This change is currently delayed. Once a new date is [...]

Membership Rosters

Membership Rosters Jurisdiction 6 and Jurisdiction K Home Health POE Advisory Group Roster Member Provider/Institution State Anderson, Jade Promedica Senior Care (Heartland Home Health) Multi [...]

Telehealth Changes for 2024 – Modifier 95 and Place of Service Codes

Telehealth Changes for 2024 – Modifier 95 and Place of Service Codes National Government Services has received many questions regarding the use of modifier 95 going forward. CMS implemented the usage of modifier 95 during the COVID-19 PHE as a [...]

2024 Annual Update to the Therapy Code List: Caregiver Training Codes

2024 Annual Update to the Therapy Code List: Caregiver Training Codes The CMS annual update to the therapy code list includes three new caregiver training “sometimes therapy” codes to include caregiver training when the patient is not [...]

2024 Annual Update to the Therapy Code List: Remote Therapeutic Monitoring

2024 Annual Update to the Therapy Code List: Remote Therapeutic Monitoring CMS is updating Disposition 10, in addition to other modifications, to clarify that, for RTM services, physical and occupational therapists in private practice may [...]