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This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
CMS updated guidelines for critical care services effective January 1, 2022. These updates were implemented, and address billing and coding processes.
This article summarizes the Medicare E/M guidelines for split or shared E/M services effective in 2024.
Providers may be billing these services incorrectly. Please review this article and pay close attention to the billing loop and segment information detailed within. The NCT number has been added to the instructions.
Learn how to submit a provider enrollment appeal in the form of a corrective action plan or reconsideration request.
The requirements for the submission of claims under reciprocal billing and fee-for-time compensation arrangements are the same for assigned and non-assigned claims. This article shows when these requirements apply.
Learn the correct pairing of value codes (VC) and payer codes (PC) to use when billing different types of Medicare secondary payer (MSP) claims.
Payment for ambulatory surgical centers (ASCs) are made under a separate payment system. As such, certain modifiers are specific to ASCs. This article explores these modifiers.
Here are additional educational resources identified specifically for hospice and home health care.
Physicians who certify patient eligibility for hospice services must enroll in Medicare or opt out effective for claims submitted on October 7, 2024 and after with dates of service June 3, 2024 or later.