Billing
Cardiac and pulmonary rehabilitation programs
Medicare pays for cardiac rehabilitation (CR), intensive cardiac rehabilitation (ICR), and pulmonary rehabilitation (PR) programs if specific criteria are met. This criterion includes coverage…
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…
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.
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).
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…
Reporting manifestation diagnosis codes
The January Integrated Outpatient Code Editor (IOCE) expands editing related to manifestation diagnosis codes. Read this article to find out more about the editing.
Advanced care planning (ACP)
Advanced care planning (ACP) is a separate Part B service enabling Medicare patients to make important decisions over the type of care they receive and when they receive it. Learn more.
Advanced care planning (ACP)
Advanced care planning (ACP) is a separate Part B service enabling Medicare patients to make important decisions over the type of care they receive and when they receive it. Learn more.
End-stage renal disease (ESRD) monthly capitation payment (MCP) claims
Billing ESRD monthly capitation payment claims correctly is important. Read this article to learn more about billing these claims.