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When a patient enrolls in or disenrolls from a Medicare Advantage plan during his/her inpatient stay, the following factors will determine whether to bill the Medicare Advantage plan and/or original Medicare.
Find information on vaccine payment allowances and fee schedules, links to related enrollment for mass immunizers, and more. Recent additions include upcoming vaccine administration coding updates beginning July 1, 2026, for TOFIDENCE® IV i…
Review the revised listing of CPT category III T codes that require documentation to avoid negative impacts to your claims.
This article provides information regarding unsolicited / voluntary refunds, that is, monies received by Medicare not related to an open account receivable.
Effective July 6, 2026, outpatient claims with type of bills (TOB) 13X or 14X will be returned to provider (RTP) for reason code 34554 if modifier ER, PO, or PN is billed on all service lines, and the practice location address is missing fr…
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.