Home ►
Billing news ►
Update to Medicare deductible, coinsurance, and premium rates: 2022-2024
Last Modified: 8/12/2024
Location: FL, PR, USVI
Business: Part A, Part B
Effective date: January 1, 2024
Implementation date: January 2, 2024
CMS issued the 2024 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee-for-service (FFS) program. The 2024 deductible, coinsurance and base premium rates are:
Part A - Hospital insurance
Deductible: $1,632.00
Coinsurance
• $408.00 a day for days 61 through 90
• $816.00 a day for days 91 through 150 (lifetime reserve days)
• $204.00 a day for days 21 through 100 (skilled nursing facility coinsurance)
Part B - Supplementary medical insurance (SMI)
Under Part B of the Medicare supplementary medical insurance (SMI) program, enrollees are subject to a monthly premium. Most SMI services are subject to an annual deductible and coinsurance (percent of costs that the enrollee must pay), which are set by statute.
Standard premium: $174.70 a month
Deductible: $240.00 a year
Coinsurance: 20%
Source: MM13365
Effective date: January 1, 2023
Implementation date: January 3, 2023
CMS issued the 2023 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee-for-service (FFS) program. The 2023 deductible, coinsurance and base premium rates are:
Part A - Hospital insurance
Deductible: $1,600.00
Coinsurance
• $400.00 a day for days 61 through 90
• $800.00 a day for days 91 through 150 (lifetime reserve days)
• $200.00 a day for days 21 through 100 (skilled nursing facility coinsurance)
Part B - Supplementary medical insurance (SMI)
Under Part B of the Medicare supplementary medical insurance (SMI) program, enrollees are subject to a monthly premium. Most SMI services are subject to an annual deductible and coinsurance (percent of costs that the enrollee must pay), which are set by statute.
Standard premium: $164.90 a month
Deductible: $226.00 a year
Coinsurance: 20%
Details are available in MLN Matters
article
MM12903 .
KX modifier thresholds
Section 50202 of the Bipartisan Budget Act of 2018 repeals the application of the therapy caps while also retaining and adding limitations to ensure appropriate therapy. A provision of section 50202 of the BBA of 2018 adds section 1833(g)(7)(A) of the Act to preserve the former therapy cap amounts as thresholds above which claims must include the KX modifier to confirm that services are medically necessary as justified by appropriate documentation in the medical record.
These amounts are now known as the KX modifier thresholds:
PT and SLP services combined: $2,230
OT services: $2,230
Effective date: January 1, 2022
Implementation date: January 3, 2022
CMS issued the 2022 deductibles, coinsurance, and premium rates for beneficiaries covered through the Medicare fee-for-service (FFS) program. The 2022 deductible, coinsurance and base premium rates are:
Part A - Hospital insurance
Deductible: $1,556.00
Coinsurance
• $389.00 a day for days 61 through 90
• $778.00 a day for days 91 through 150 (lifetime reserve days)
• $194.50 a day for days 21 through 100 (skilled nursing facility coinsurance)
Part B - Supplementary medical insurance (SMI)
Under Part B of the Medicare supplementary medical insurance (SMI) program, enrollees are subject to a monthly premium. Most SMI services are subject to an annual deductible and coinsurance (percent of costs that the enrollee must pay), which are set by statute.
Standard premium: $170.10 a month
Deductible: $233.00 a year
Coinsurance: 20%
Details are available in MLN Matters
article
MM12507 .
Source: CR13365
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.