2020 Part B MAC Update

The April 2021 quarterly update includes revisions to the Part B SNF CB files for 2021, 2020, 2019, and 2017.

The revisions to the Part B SNF CB files for 2020 included in this update (effective with the April 5, 2021 implementation of CR 12212) are as follows:

Revisions to 2020 Files

File 1

Addition of COVID-19 Vaccine and Vaccine Administration Codes and Monoclonal Antibody Treatment and Treatment Administration Codes:

•  Effective November 9, 2020 - Bamlanivimab – Q0239, M0239
• Effective November 21, 2020 - Casirivimab + Imdevimab – Q0243, M0243
• Effective December 11, 2020 - Pfizer – 91300, 0001A, 0002A
• Effective December 18, 2020 - Moderna – 91301, 0011A, 0012A

(dose 2)

We also added the following HCPCS codes:

• 98966 Hc pro phone call 5-10 min
• 98967 Hc pro phone call 11-20 min
• 98968 Hc pro phone call 21-30 min.

File 4

Deletion of the following HCPCS codes effective January 1, 2020 per CR 11501:

• 95831 - 95834
• G8978-G8999
• G9158-G9176
• G9186

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The SNF consolidated billing files reflect new codes that have been developed for 2020 and codes that have been discontinued for 2020. In addition, the files reflect any additions and deletions to categories of services excluded from consolidated billing. These files are effective for claims with dates of service on or after 1/01/2020 unless otherwise noted.

Effective October 1, 2019 the following changes are made to File #1 - Physician Services for SNF CB:

Add

Major Category III. A. – Chemotherapy retroactive to October 1, 2019

J0641-Inj.,levoleucorvin, nos, 0,5mg

J0642-Inj., levoeucorvin, khapzory, 0,5mg

Remove

Part B Therapy Code

29580 - paste/unna boot

29581-29584 - application of multi compression systems

Note: The action to remove 29580 and 29581-29584 is retroactive to January 1, 2015.
 

Effective January 1, 2020, the following changes are made to file #1 – Part A Stay Physician Services

Add

Major Category III. A

J9030 - Bcg live intravesical 1mg

J9036 - Inj. belrapzo/bendamustine

J9118 - Inj. Calaspargase pegol-mknl

J9119 - Inj., cemiplimab-rwlc, 1 mg

J9269 - Inj. tagraxofusp-erzs 10 mcg

J9313 - Inj., lumoxiti, 0.01 mg

J9356 - Inj. herceptin hylecta, 10mg

Q5112 - Inj ontruzant 10 mg

Q5113 - Inj herzuma 10 mg

Q5114 - Inj ogivri 10 mg

Q5115 - Inj truxima 10 mg

Q5116 - Inj., trazimera, 10 mg

Q5117 - Inj., kanjinti, 10 mg

Q5118 - Inj., zirabev, 10 mg

Remove

CPT 90912 – Biofeedback Training

CPT 90913 – Biofeedback Training

CPT 97129 – Therapeutic Intervention

CPT 97130 - Therapeutic Intervention

Revise

J9355 - Inj trastuzumab excl biosimi

 

Effective October 1, 2019, the following changes are made to File #4 – Part B Stay Only Therapy. 

Add

29580 - paste/unna boot

29581 - Lower Extremity Application of Strapping-Any Age

29584 - Lower Extremity Application of Strapping-Any Age

Note: This action is retroactive to January 1, 2015.

 

Effective January 1, 2020, the following changes are made to the File #4 – Part B Stay Only Therapy.

Add

CPT 90912 – Biofeedback Training

CPT 90913 – Biofeedback Training

CPT 97129 – Therapeutic Intervention

CPT 97130 - Therapeutic Intervention