Public health emergency billing guidance for skilled nursing facilities (SNFs)
CMS allows programmatic waivers for impacted states under Section 1135 of the Social Security Act (SSA) for declared emergencies...
Collaborative parenteral nutrition webinar coming December 9
This is your opportunity to hear directly from the Medicare contractors regarding Medicare’s criteria necessary for the coverage...
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Please take a moment to complete our customer service satisfaction survey when calling the Provider Contact Center.
Physical therapy plan of care requirements
When billing for rehabilitation therapy services, there are some documentation requirements that must be met to comply with the...
Prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services
CMS is delaying the start date for the PA demonstration for certain services provided in ASCs and will be implementing the...
Tips to prevent reason code 326x4
Review this article if your claim is returning for reason code 326x4.
Update on Medicare Operations: Telehealth, Claims Processing, and Medicare Administrative Contractors Status During the Shutdown
View this notice from CMS regarding Medicare operations during the government shutdown.
Outlier reconciliation criteria for IPPS and LTCH PPS hospitals
View this information about outlier reconciliation criteria for IPPS and LTCH PPS hospitals and the latest CMS change request.
Where can I find diagnosis codes for chiropractic services?
For chiropractic services to be covered, they must be reasonable and necessary, and meet CMS guidelines. You can find diagnosis coding guidelines in our local coverage article, A58412 - Billing and Coding: Chiropractic Services.
What is modifier AT and when do we report it?
Modifier AT (active treatment) defines the difference between active treatment and maintenance treatment.
The AT modifier is required under Medicare billing to receive reimbursement for CPT codes 98940-98942. For Medicare purposes, the AT modifier is used only when chiropractors bill for active / corrective treatment (acute and chronic care).
Every chiropractic claim for 98940 / 98941 / 98942, should include the AT modifier if active / corrective treatment is being performed. Claims that do not contain modifier AT will deny.