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This article includes a quick reference table that will help the billing staff of providers, physicians, and other suppliers determine whether Medicare is the primary or secondary payer based upon specific situational criteria. The informat…
This article will assist Medicare Part B providers with proper billing relating to COVID-19 vaccine and monoclonal antibody infusion. Beneficiary coinsurance and deductible are waived.
Effective January 1, 2024, IOP services are available for both individuals with mental health conditions and individuals with substance use disorders. This article addresses institutional billing requirements for these new services.
This information outlines the process for the 935 recoupment.
This article provides guidance to avoid inappropriately billing Qualified Medicare Beneficiaries (QMBs) for Medicare cost-sharing, including deductibles, coinsurance, and copayments.
Medicare applies a MPPR to the payment of select therapy services. The reduction applies to HCPCS codes contained on the list of “always therapy” services, regardless of the type of provider or supplier furnishing the services. Find out the…
The Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of voluntarily developed and implemented compliance plans. The OIG has supplied guidance as to the elements of a model compliance plan.
The supply codes list has been updated.
The Jimmo Settlement Agreement clarifies Medicare’s longstanding policy coverage of skilled nursing and skilled therapy services. Please read this article and access the link within the article for more information.
Read this article to learn more about billing a skilled nursing facility (SNF) leave of absence claim.