-
Posting Date: 06/24/2025
LCD and Billing and Coding Article Updates – 2025
LCD and Billing and Coding Article Updates – 2025 January Psychiatric Partial Hospitalization Programs L33626 Effective 1/1/2024, in the Coverage Indications, Limitations and/or Medical Necessity section, the third list under Limitations has [...]
Read More -
Posting Date: 08/06/2015
Medical Necessity of Ambulance Services
Medical Necessity of Ambulance Services Table of Contents Medical Necessity of Ambulance Services What You Can Do Nearest Appropriate Facility: GY Modifier What You Can Do Related Content [Return to Top] Medical [...]
Read More -
Posting Date: 11/12/2020
Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity
Responsibility of Providing a Properly Executed Physician Certification Statement/Certificate of Medically Necessity Recent National Government Services educational efforts have highlighted an issue between facilities and the ambulance [...]
Read More -
Posting Date: 03/03/2025
National AB Medicare Administrative Contractor Ambulance Provider/Supplier Coalition
National AB Medicare Administrative Contractor Ambulance Provider/Supplier Coalition Attention Ambulance Providers In response to numerous and continued requests from the ambulance community, the AB MACs have put together a National AB MAC [...]
Read More -
Posting Date: 03/26/2025
Hospital-Based Ambulance Basic Billing Guidelines
Hospital-Based Ambulance Basic Billing Guidelines For hospital-based ambulance billing under Medicare, services should be billed on the UB-04 form using the ambulance service-specific NPI, not the acute hospital NPI, and claims for inpatient [...]
Read More -
Posting Date: 01/31/2015
Ambulance Transports Included in SNF Consolidated Billing
Ambulance Transports Included in SNF Consolidated Billing Transport Description Medical Necessity Met Ambulance Billing Modifiers and Other Considerations Who is Responsible for Payment? Reference(s) SNF to [...]
Read More -
Posting Date: 06/26/2025
MLN Connects® Newsletter: June 26, 2025
MLN Connects® Newsletter: June 26, 2025 News Alert: Medicare Fraud Scheme Involving Phishing Fax Requests Medicare Diabetes Prevention Program: CY 2025 Payment Rates Compliance Commodes, Bed Pans & Urinals: Prevent Claim Denials [...]
Read More -
Posting Date: 03/26/2024
Self-Administered Drug Exclusion (J6 and JK)
Self-Administered Drug Exclusion Update (J6 and JK) Medications that are self-administered more than 50% of the time for all Medicare beneficiaries are excluded from Medicare Part B coverage. At the direction of CMS, each MAC shall [...]
Read More