This edition includes information on manufacturer participation in Medicare drug price negotiation, the Medicare Shared Savings Program application deadline, the ESRD prospective payment system, and more.
CMS recently revised the code descriptor for HCPCS code G0136 to remove the social determinants of health risk (SDOH) assessment. The code remains on the Medicare telehealth services list. View this article for details on the new assessment…
To enhance efficiency and ensure the secure handling of appeal information, effective May 1, 2026, all providers will be required to use SPOT to check appeal status and access duplicate appeal decision letters.
We'd like to remind providers of medical documentation you'll need to submit when filing a redetermination or clerical error reopening for a claim (or line item) denied due to an MUE.
This article contains the conversion factors for use in calculating payment for anesthesia services (procedure codes 00100 through 01999) for service dates January 1 through December 31, 2023 (revised July 2023).