Behavioral Health Integration

Behavioral Health Integration Table of Contents BHI Overview Eligible Conditions Part B Billing/Coding BHI Services New Coding and Payment for BHI Conditions Billed by Clinical Psychologists and Clinical Social Workers Initiating [...]

CERT Awareness Week One – 2025 CERT Documentation Deadline

CERT Awareness Week One – 2025 CERT Documentation Deadline  The Part A, Part B, DME, home health and hospice, and Railroad Board MACs are working together to promote the importance of complying with CERT documentation requests. This is [...]

Prior Authorization Outpatient Department Exemption and ABN ADRs

Prior Authorization Outpatient Department Exemption and ABN ADRs National Government Services Prior Authorization initiated the process of issuing ADRs to 2025 exempt providers. Historically, claims await a provider’s response in FISS DDE [...]

Chronic Care Management

Chronic Care Management Table of Contents Billing Codes Chronic Pain Management and Treatment Codes Billing and Documentation Care management for chronic conditions Related Content [Return to Top] Billing Codes 99490: Provide at [...]

Cognitive Assessment

Cognitive Assessment Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99483: 60 minute face-to-face [Return to Top] Billing Information Cognitive assessment [...]

Transitional Care Management

Transitional Care Management Table of Contents Billing Codes Billing Information Documentation Related Content [Return to Top] Billing Codes 99495: Moderate complexity F2F 7 to 14 days 99496: High complexity F2F 7 days [...]

Psychiatric Collaborative Care Model

Psychiatric Collaborative Care Model The psychiatric CoCM was introduced in 2018 and Medicare began making separate payments using CPT codes 99492, 99493 and 99494. Effective 1/1/2021, G2214 was added to Psychiatric CoCM to cover shorter [...]

Radiopharmaceutical Reimbursement National Government Services has reviewed the radiopharmaceutical pricing methodology set forth in the Medicare Prescription Drug, Improvement, and Modernization Act of 2003, Section 303(h) which states that [...]