Billing
Dental services coverage
If you’re a new or seasoned provider billing dental services to fee-for-service (FFS) Medicare, or original Medicare, this article guides you through recently clarified payment provisions for dental…
Pre-exposure prophylaxis (PrEP) using antiretroviral drugs to prevent human immunodeficiency virus (HIV) infection
Read this article for information on billing PrEP for HIV drugs.
Intensive outpatient program (IOP) billing requirements for institutional services
Effective January 1, 2024, IOP services are available for both individuals with mental health conditions and individuals with substance use disorders. This article addresses institutional billing…
Immunization
Find information on vaccine payment allowances and fee schedules, links to related enrollment for mass immunizers, and more. Recent additions include upcoming vaccine administration coding updates…
Immunization
Find information on vaccine payment allowances and fee schedules, links to related enrollment for mass immunizers, and more. Recent additions include upcoming vaccine administration coding updates…
COVID-19 vaccine and monoclonal antibody billing for Part B providers
This article will assist Medicare Part B providers with proper billing relating to COVID-19 vaccine and monoclonal antibody infusion. Beneficiary coinsurance and deductible are waived.
Skilled nursing facility (SNF) leave of absence
Read this article to learn more about billing a skilled nursing facility (SNF) leave of absence claim.
Prohibition on billing dually eligible individuals enrolled in the Qualified Medicare Beneficiary (QMB) program
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
Prohibition on billing dually eligible individuals enrolled in the Qualified Medicare Beneficiary (QMB) program
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
Inpatient hospital entitlement changes
When a patient enrolls in or disenrolls from a Medicare Advantage plan during his/her inpatient stay, the following factors will determine whether to bill the Medicare Advantage plan and/or original…