Billing

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Behavioral health services

Medicare covers behavioral, mental and psychiatric health services that may improve outcomes for Medicare patients. For more information, please view this article and share these valuable resources…

Physician supervision of diagnostic tests

The Code of Federal Regulations requires that, with certain exceptions, diagnostic tests covered under the Social Security Act and payable under the physician fee schedule must be performed under the…

Physician supervision of diagnostic tests

The Code of Federal Regulations requires that, with certain exceptions, diagnostic tests covered under the Social Security Act and payable under the physician fee schedule must be performed under the…

End stage renal disease (ESRD): Payment for phosphate binders effective January 1

Effective January 1, phosphate binders are paid as a renal dialysis service under Medicare Part B. Read this article to learn more.

Travel allowance for collection of specimens

Read this article to learn more about the travel allowance paid for the collection of specimens.

Syfovre (J2781) removed from injection frequencies system editing

Read this article to learn more about J2781 being removed from injection frequency editing.

Clinicians: Are you ordering urological supplies for your patients?

Urological supplies are covered as part of the Prosthetic Device benefit as outlined in the Social Security Act § 1861(s)(8).

How to use modifiers to indicate the status of an ABN

Learn which modifier to use when you expect Medicare will deny a claim that does not meet medical necessity criteria and whether you have or do not have an advanced beneficiary notice (ABN) signed by…

How to use modifiers to indicate the status of an ABN

Learn which modifier to use when you expect Medicare will deny a claim that does not meet medical necessity criteria and whether you have or do not have an advanced beneficiary notice (ABN) signed by…

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…