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Posting Date: Thu Mar 28 00:00:00 GMT 2024
MLN Connects® Newsletter: March 28, 2024

MLN Connects® Newsletter: March 28, 2024 Proposed Payment Rule FY 2025 Inpatient Rehabilitation Facility Prospective Payment System Proposed Rule News CMS Roundup (Mar 22, 2024) Hospital Price Transpa...

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Posting Date: Wed Mar 27 00:00:00 GMT 2024
Drugs and Biologicals

Drugs and Biologicals We’ve updated the drugs and biologicals section of our website to offer easier navigation to the information you need. Updates include: Created a left-side navigation list with h...

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Posting Date: Wed Mar 27 00:00:00 GMT 2024
A/B and DME Collaborative General Documentation Requirements

A/B and DME Collaborative General Documentation Requirements The A/B and DME Collaborative General Documentation Requirements YouTube Video is available. Posted 3/27/2024

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Posting Date: Wed Mar 27 00:00:00 GMT 2024
NGSConnex Part B Claim Submission Issue – Mammography Claims

NGSConnex Part B Claim Submission Issue - Mammography Claims At this time, we are unable to accept mammography claims through Part B Claim Submission in NGSConnex. We are working to resolve the issue;...

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Posting Date: Mon Mar 25 00:00:00 GMT 2024
Attention Electronic Billers

Attention Electronic Billers National Government Services has experienced issues with electronic files downloaded by some of our trading partners (those who receive electronic files directly from NGS)...

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Posting Date: Mon Mar 25 00:00:00 GMT 2024
Attention! New CMS-588 Electronic Funds Transfer Authorization Agreement (11/23) Version

Attention! New CMS-588 Electronic Funds Transfer Authorization Agreement (11/23) Version Effective 4/30/2024 the MACs may only accept the CMS-588 EFT (11/23) version, the outdated form will be returne...

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Posting Date: Mon Mar 25 00:00:00 GMT 2024
LCD and Article Updates for March/April 2024

LCD and Article Updates for March/April 2024 Local Coverage Determinations Fluid Jet System Treatment for LUTS/BPH (L38367) The age limitation of >80 years of age has been removed, effective for servi...

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Posting Date: Fri Mar 22 00:00:00 GMT 2024
Important Reminder: Change Healthcare Security Incident

Important Reminder: Change Healthcare Security Incident This is an important reminder related to the Change Healthcare Security Incident and the efforts of the CMS and National Government Services. Ch...

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Posting Date: Thu Mar 21 00:00:00 GMT 2024
[REVISED] Submitting Paper Claim Forms to National Government Services Due to the Change Healthcare Security Incident

[REVISED] Submitting Paper Claim Forms to National Government Services Due to the Change Healthcare Security Incident As a follow up to our 2/28/2024 article, Change Healthcare Security Incident, prov...

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Posting Date: Thu Mar 21 00:00:00 GMT 2024
Inquiry Reference Numbers Are Now Available on the IVR

Inquiry Reference Numbers Are Now Available on the IVR You can now get an inquiry reference number through the IVR. Once the caller makes a selection from the main menu, the IVR will ask, "Would you l...

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Posting Date: Thu Mar 21 00:00:00 GMT 2024
MLN Connects® Newsletter: March 21, 2024

MLN Connects® Newsletter: March 21, 2024 News New Initiative to Increase Investments in Person-Centered Primary Care Marriage and Family Therapists & Mental Health Counselors: Get Information about Bi...

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Posting Date: Tue Mar 19 00:00:00 GMT 2024
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 i...

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Posting Date: Tue Mar 19 00:00:00 GMT 2024
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: Treat...

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Posting Date: Thu Mar 14 00:00:00 GMT 2024
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 ...

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Posting Date: Thu Mar 14 00:00:00 GMT 2024
Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated and Advance Payments for Part A Providers and Part B Suppliers Frequently Asked Questions

Change Healthcare/Optum Payment Disruption (CHOPD) Accelerated and Advance Payments for Part A Providers and Part B Suppliers Frequently Asked Questions Please see the below for the latest FAQs relate...

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Posting Date: Wed Mar 13 00:00:00 GMT 2024
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 ...

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Posting Date: Tue Mar 12 00:00:00 GMT 2024
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 vit...

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Posting Date: Mon Mar 11 00:00:00 GMT 2024
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 web...

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Posting Date: Mon Mar 11 00:00:00 GMT 2024
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 Advan...

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Posting Date: Mon Mar 11 00:00:00 GMT 2024
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...

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Posting Date: Thu Mar 07 00:00:00 GMT 2024
NGSMedicare.com Scheduled Maintenance: 3/9/2024-3/10/2024

NGSMedicare.com Scheduled Maintenance Due to scheduled maintenance, NGSMedicare.com will be inaccessible beginning Saturday, 3/9/2024 through Sunday, 3/10/2024. We apologize for any inconvenience this...

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Posting Date: Thu Mar 07 00:00:00 GMT 2024
MLN Connects® Newsletter: March 7, 2024

MLN Connects® Newsletter: March 7, 2024 News HHS Statement Regarding the Cyberattack on Change Healthcare Final Guidance to Help People with Medicare Prescription Drug Coverage Manage Prescription Dru...

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Posting Date: Wed Mar 06 00:00:00 GMT 2024
Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport

Prior Authorization Process for Repetitive Scheduled Nonemergent Ambulance Transport CMS implemented the prior authorization program for RSNAT to reduce expenditures while maintaining and/or improving...

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Posting Date: Thu Feb 29 00:00:00 GMT 2024
MLN Connects® Newsletter: February 29, 2024

MLN Connects® Newsletter: February 29, 2024 Events ICD-10 Coordination & Maintenance Committee Meeting — March 19–20 MLN Matters® Articles Appropriate Use Criteria for Advanced Diagnostic Imaging: CY ...

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Posting Date: Thu Feb 29 00:00:00 GMT 2024
Tobacco Counseling via Telehealth

Tobacco Counseling via Telehealth Tobacco use is the leading cause of preventable disease, disability and death in the United States. Each year, nearly half a million Americans die prematurely of smok...

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Posting Date: Thu Feb 29 00:00:00 GMT 2024
You Asked, We Listened: Redesigned Events Page Coming Soon

You Asked, We Listened: Redesigned Events Page Coming Soon We’re always looking for and appreciate feedback from our providers. Your ideas and recommendations help drive improvements to our website. P...

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Posting Date: Tue Feb 27 00:00:00 GMT 2024
Medicare Preventive Services

Medicare Preventive Services Medicare covers many preventive services to help keep your patients healthy. Preventive services can help find health problems early, when treatment works best, and can he...

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Posting Date: Tue Feb 27 00:00:00 GMT 2024
LCD and Billing and Coding Article Updates for February/March 2024

LCD and Billing and Coding Article Updates for February/March 2024 Local Coverage Determinations Biomarker Testing for Prostate Cancer Diagnosis (L37733) This LCD has been retired and will no longer b...

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Posting Date: Tue Feb 27 00:00:00 GMT 2024
[REVISED] 2024 Gapfill Request

[REVISED] 2024 Gapfill Request National Government Services, the MAC for JK and J6 is in receipt of the new laboratory test codes identified by the CMS to be gap-fill priced for 2024. The PAMA regulat...

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Posting Date: Tue Feb 27 00:00:00 GMT 2024
Change Healthcare Security Incident

Change Healthcare Security Incident The CMS and National Government Services are aware that Change Healthcare recently suffered a cyber-attack. Change Healthcare is a clearinghouse vendor that connect...

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Posting Date: Mon Feb 26 00:00:00 GMT 2024
Prolonged Services Timeline 2024

Prolonged Services Timeline 2024 We’ve updated the Prolonged Services Timetable with 2024 HCPCS and CPT codes, time requirements and date spans. We encourage providers to view this information to ensu...

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Posting Date: Mon Feb 26 00:00:00 GMT 2024
Medicare Part B Overpayments

Medicare Part B Overpayments We developed the Medicare Part B Overpayments Tip Sheet to provide instructions for reporting various overpayment situations. Topics include responding to a demand letter,...

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Posting Date: Thu Feb 22 00:00:00 GMT 2024
Evaluation and Management Frequently Asked Questions

Evaluation and Management Frequently Asked Questions We’ve expanded our E/M FAQs for the Complex and Chronic Care – HCPCS code G2211 category to include answers to common questions we’ve received abou...

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Posting Date: Thu Feb 22 00:00:00 GMT 2024
MLN Connects® Newsletter: February 22, 2024

MLN Connects® Newsletter: February 22, 2024 News CMS Issues Additional Guidance on Program to Allow People with Medicare to Pay Out-of-Pocket Prescription Drug Costs in Monthly Payments Compliance Med...

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Posting Date: Wed Feb 21 00:00:00 GMT 2024
Common Working File (CWF) Host Dark Days for April 2024 Release

Common Working File (CWF) Host Dark Days for April 2024 Release For the upcoming April 2024 Release: For Production, CWF will be observing the Gray Day on Thursday, 3/28/2024 and Dark Days starting Fr...

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Posting Date: Tue Feb 20 00:00:00 GMT 2024
Health Benefits of Quitting Smoking

Health Benefits of Quitting Smoking Help your Patients Kick the Habit! Smoking leads to multiple diseases and potentially death, but this is preventable – anyone at any age can benefit from quitting s...

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Posting Date: Fri Feb 16 00:00:00 GMT 2024
[REVISED] Provisional Period of Enhanced Oversight for New Hospices

[REVISED] Provisional Period of Enhanced Oversight for New Hospices In an effort to reduce hospice fraud, waste and abuse, CMS is placing newly enrolling hospices located in Arizona, California, Nevad...

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Posting Date: Thu Feb 15 00:00:00 GMT 2024
MLN Connects® Newsletter: February 15, 2024

MLN Connects® Newsletter: February 15, 2024 News CMS Roundup (Feb 9, 2024) Marriage and Family Therapists & Mental Health Counselors: New Specialty Codes for Medicare Medicare Physician Fee Schedule D...

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Posting Date: Wed Feb 14 00:00:00 GMT 2024
National Government Services Will Be Open On President's Day

National Government Services Will Be Open On President's Day National Government Services will be open on President's Day, Monday, 2/19/2024. The PCC will be open and available to take your calls. Pos...

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Posting Date: Thu Feb 08 00:00:00 GMT 2024
MLN Connects® Newsletter: February 8, 2024

MLN Connects® Newsletter: February 8, 2024 News Medicare Shared Savings Program: Application Deadlines for a January 1, 2025, Start Date New Dental Specialty Codes for Medicare Hospices & Skilled Nurs...

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Posting Date: Thu Feb 08 00:00:00 GMT 2024
National Government Services Proposed LCDs for Comment

National Government Services Proposed LCDs for Comment The proposed LCDs listed below are being presented for comment for the Jurisdiction 6 and Jurisdiction K MACs. The formal comment period extends ...

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Posting Date: Thu Feb 08 00:00:00 GMT 2024
Reminder: Jurisdiction 6 and Jurisdiction K Providers Using Medicare Part B MSP Overpayment Request Form for Non-MSP

Reminder: Jurisdiction 6 and Jurisdiction K Providers Using Medicare Part B MSP Overpayment Request Form for Non-MSP Use the Medicare Part B MSP Overpayment Request Form for the following situations, ...

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Posting Date: Mon Feb 05 00:00:00 GMT 2024
Correct Coding of Molecular Testing Panels (Revised)

Correct Coding of Molecular Testing Panels (Revised) The submission of claims using individual gene CPT codes, when gene panels are ordered, is considered incorrect coding. Correct coding requires tha...

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Posting Date: Thu Feb 01 00:00:00 GMT 2024
MLN Connects® Newsletter: February 1, 2024

MLN Connects® Newsletter: February 1, 2024 News Participation Continues to Grow in CMS' Accountable Care Organization Initiatives in 2024 CMS Roundup (Jan 26, 2024) Claims, Pricers, & Codes HCPCS Appl...

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Posting Date: Tue Jan 30 00:00:00 GMT 2024
2023 Calendar Year 1099 Form Information

2023 Calendar Year 1099 Form Information National Government Services will mail all 1099 Forms for Calendar Year 2023 by 1/31/2024 Medicare providers and beneficiaries, who are serviced by NGS regardl...

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Posting Date: Tue Jan 30 00:00:00 GMT 2024
2024 Telehealth Billing – Item 32 Address Completion Clarification

2024 Telehealth Billing – Item 32 Address Completion Clarification National Government Services is providing this article for clarification on the billing of telehealth services; specifically, the ...

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Posting Date: Mon Jan 29 00:00:00 GMT 2024
KX Modifier on Outpatient Physical Therapy, Occupational Therapy or Speech Language Pathology Claims CY 2024

KX Modifier on Outpatient Physical Therapy, Occupational Therapy or Speech Language Pathology Claims Calendar Year 2024 KX Modifier Threshold The BBA of 2018 repealed application of the Medicare outpa...

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Posting Date: Fri Jan 26 00:00:00 GMT 2024
Fiscal Intermediary Standard System Direct Data Entry Screen Changes – January 2024

Fiscal Intermediary Standard System Direct Data Entry Screen Changes – January 2024 The January 2024 quarterly system release was implemented on 1/2/2024 with two minor changes to certain DDE screens....

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Posting Date: Fri Jan 26 00:00:00 GMT 2024
A/B DME MAC Collaborative Webinar: General Documentation Requirements

A/B DME MAC Collaborative Webinar: General Documentation Requirements Physicians/Practitioners! Are you ordering durable medical equipment, prosthetics, orthotics and supplies for your patients? This ...

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Posting Date: Thu Jan 25 00:00:00 GMT 2024
MLN Connects® Newsletter: January 25, 2024

MLN Connects® Newsletter: January 25, 2024 News CMS Announces New Actions to Help Hospitals Meet Obligations under EMTALA CMS Announces New Model to Advance Integration in Behavioral Health Doctor & C...

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Posting Date: Wed Jan 24 00:00:00 GMT 2024
Medicare Participating Physicians Directory

Medicare Participating Physicians Directory The 2024 MEDPARD is now available. It includes all Part B providers in Jurisdiction 6 and Jurisdiction K who have agreed to accept assignment on all Medicar...

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Posting Date: Wed Jan 24 00:00:00 GMT 2024
LCD and Billing and Coding Article Updates January/February 2024

LCD and Billing and Coding Article Updates January/February 2024 Billing and Coding: Off-Label Use of Intravenous Immune Globulin (IVIG) (A59105) A list of labeled and compendia approved diagnoses hav...

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Posting Date: Tue Jan 23 00:00:00 GMT 2024
Frequently Asked Questions Have Been Reviewed

Frequently Asked Questions Have Been Reviewed We’ve reviewed and updated our educational FAQs. Visit our Help and FAQs page located within the Education section of our website. Please take time to rev...

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Posting Date: Tue Jan 23 00:00:00 GMT 2024
Credit Balance Report Reminder: Due Date Approaching

Credit Balance Report Reminder: Due Date Approaching For the quarter ending 12/31/2023, CBRs can be submitted starting 1/1/2024 and must be submitted within 30 days to be considered timely. The easies...

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Posting Date: Mon Jan 22 00:00:00 GMT 2024
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 caregive...

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Posting Date: Mon Jan 22 00:00:00 GMT 2024
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 occupatio...

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Posting Date: Mon Jan 22 00:00:00 GMT 2024
The Part B Top Claim Errors Have Been Reviewed and Updated

The Part B 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 to learn what you can do to avoi...

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Posting Date: Mon Jan 22 00:00:00 GMT 2024
The Part A Top Claim Errors Have Been Reviewed

The Part A Top Claim Errors Have Been Reviewed Our top claim errors are updated on a quarterly basis to reflect current information. Visit Top Claim Errors to learn what you can do to avoid claim proc...

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Posting Date: Mon Jan 22 00:00:00 GMT 2024
The Home Health and Hospice Top Claim Errors Have Been Reviewed

The Home Health and Hospice Top Claim Errors Have Been Reviewed Our top claim errors are updated on a quarterly basis to reflect current information. Visit Top Claim Errors to learn what you can do to...

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Posting Date: Fri Jan 19 00:00:00 GMT 2024
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...

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Posting Date: Fri Jan 19 00:00:00 GMT 2024
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 ...

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Posting Date: Thu Jan 18 00:00:00 GMT 2024
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 Round...

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Posting Date: Thu Jan 18 00:00:00 GMT 2024
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 ...

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Posting Date: Thu Jan 18 00:00:00 GMT 2024
Frequently Asked Questions Have Been Reviewed and Updated

Frequently Asked Questions Have Been Reviewed and Updated We’ve reviewed and updated our educational FAQs. Visit our Help and FAQs page located within the Education section of our website. Topics avai...

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Posting Date: Thu Jan 11 00:00:00 GMT 2024
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...

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Posting Date: Thu Jan 11 00:00:00 GMT 2024
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

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Posting Date: Wed Jan 10 00:00:00 GMT 2024
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 c...

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Posting Date: Fri Jan 05 00:00:00 GMT 2024
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...

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Posting Date: Thu Jan 04 00:00:00 GMT 2024
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 provisio...

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Posting Date: Thu Jan 04 00:00:00 GMT 2024
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 ...

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Posting Date: Wed Jan 03 00:00:00 GMT 2024
Hospice Cap Self-Reporting Reminder for the 2023 Cap Year

Hospice Cap Self-Reporting Reminder for the 2023 Cap Year The Hospice Cap Self-Reporting for the 2023 Cap Year (10/1/2022-9/30/2023) is due no later than 2/29/2024. Hospice providers should submit the...

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Posting Date: Tue Jan 02 00:00:00 GMT 2024
January Code Set Update for PC Print: January 2024

January Code Set Update for PC-Print: January 2024 The PC-Print January code set update will be available on our website 1/3/2024. The update contains the following enhancements: CR13303 Implement Ope...

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Posting Date: Tue Jan 02 00:00:00 GMT 2024
New Version of PC-ACE: January 2024

New Version of PC-ACE: January 2024 PC-ACE Version 6.1 contains several CMS mandates and product enhancements including but not limited to the items listed below. MLN Matters® MM13248 Revised: Process...

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Posting Date: Tue Jan 02 00:00:00 GMT 2024
New Medicare Topic – Medicare Part B Final Rule 2024

New Medicare Topic – Medicare Part B Final Rule 2024 CMS issued the final rule on 11/2/2023, which announces finalized policy changes for Medicare payments under the PFS and other Medicare Part B issu...

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Posting Date: Thu Dec 28 00:00:00 GMT 2023
Micro-invasive Glaucoma Surgery Update

Micro-invasive Glaucoma Surgery Update The MIGS LCD, L37244, and Billing and Coding Article, A56588, will not become final and therefore have been removed from the Medicare Coverage Database. Accordin...

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