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55 of 55 results

New high-cost cell-based gene therapy drug Encelto approved for use in the ambulatory surgical center (ASC) setting

Medicare approved the groundbreaking new cell-based gene therapy drug, Encelto, for use in the ambulatory surgical center setting, effective for claims with dates of service on or after October 1, 2025. This article details how to bill for…

Pre-exposure prophylaxis (PrEP) using antiretroviral drugs to prevent human immunodeficiency virus (HIV) infection

Read this article for information on billing PrEP for HIV drugs.

Interim billing guidelines for inpatient acute-care PPS hospitals, inpatient rehabilitation facilities (IRFs), long-term care hospitals (LTCHs) and inpatient psychiatric facilities (IPFs)

Review these interim billing guidelines.

Ending AX modifier requirements for acute kidney injury (AKI) and end stage renal disease (ESRD)

Effective July 1, 2026, new billing instructions apply related to no longer submitting the AX modifier and hemodiafiltration and AKI claims.

COVID-19 vaccine and monoclonal antibody billing for Part A providers

This article will assist Medicare Part A providers with proper billing relating to COVID-19 vaccine and monoclonal antibody infusion. Beneficiary coinsurance and deductible are waived.