Don’t run out of time. Remember to complete your Web-based Training (WBT) courses and save your certificates by January 31. The Medicare Learning Network (MLN) Learning Management System won’t be available starting February 1. We’re moving content to cms.gov soon.

2020 MIPS Extreme and Uncontrollable Circumstances Exception Application: Deadline February 1

To further support clinicians during the COVID-19 Public Health Emergency (PHE), CMS extended the 2020 Merit-based Incentive Payment System (MIPS) Extreme and Uncontrollable Circumstances Exception application deadline to February 1. For the 2020 performance year, MIPS eligible clinicians, groups, and virtual groups can submit an application asking us to reweight one or more performance categories to 0% due to the current COVID-19 PHE. If you have concerns about the effect of the COVID-19 PHE on your performance data, including cost measures, submit an application and cite COVID-19 as the reason for your application.

For More Information:

MIPS Extreme and Uncontrollable Circumstances Exception Application user guide and fact sheet
How to Submit an Extreme and Uncontrollable Circumstances Exception Application video
Extreme and Uncontrollable Circumstances Exception webpage
Quality Payment Program Exceptions Application fact sheet
Contact the Quality Payment Program at QPP@cms.hhs.gov or 866-288-8292; customers who are hearing impaired can dial 711 for a TRS Communications Assistant

Extension of Medicare IVIG Demonstration through December 31, 2023

The Medicare Intravenous Immune Globulin (IVIG) Demonstration was scheduled to end on December 31, 2020, but it is now extended through December 31, 2023:

Beneficiaries enrolled as of November 15, 2020, do not need to re-enroll
New beneficiaries can continue to enroll in accordance with the demonstration procedures

For information about the demonstration, visit the IVIG webpage.

Teaching Hospitals Receiving FTE Resident Caps Under Section 5506 of the Affordable Care Act

On December 22, CMS announced which teaching hospitals received increases to their Direct Graduate Medical Education (DGME) and Indirect Medical Education (IME) Full-Time Equivalent (FTE) resident caps under Round 16 of Section 5506 of the Affordable Care Act. This round redistributes the DGME and IME residency slots of Hahnemann University Hospital in Philadelphia, PA.

Section 5506 directs us to develop a process to permanently preserve and redistribute the Medicare funded residency slots from teaching hospitals that close. We give priority to hospitals that are located in the same or contiguous core-based statistical areas as the closed hospital and also meet other criteria. For more information, see the list of applicants (ZIP) for slots under Round 16 and the DGME webpage.

Cervical Health: Medicare Covers Screening Services

Medicare covers cervical and vaginal cancer screenings, and your patients pay nothing if you accept assignment. During Cervical Health Awareness Month, talk to your patients about cervical health, and encourage them to take advantage of these screenings.

For More Information:

Medicare Preventive Services educational tool
Preventive Services webpage
CDC Cervical Cancer webpage
Information for your patients on cervical and vaginal cancer screenings

Compliance

Importance of Proper Documentation: Provider Minute Video

Why is proper documentation important to you and your patients? Find out how it affects items and services, claim payment, and medical review in the Provider Minute: The Importance of Proper Documentation video. Learn about:

Top five documentation errors
How to submit documentation for a Comprehensive Error Rate Testing review
How your Medicare Administrative Contractor can help

Events

CMS-CDC Fundamentals of COVID-19 Prevention for Nursing Home Management Call — January 7

Thursday, January 7 from 4 to 5 pm ET

CMS, CDC, and the Quality Improvement Organization (QIO) Program present this live Q&A session:

Register for January 7 session
Submit questions in advance to DVACSupport@thebizzellgroup.com
Visit the QIO Program FAQ webpage

Target Audience: Clinical and administrative nursing home staff members.

MLN Matters® Articles

Addition of the QW Modifier to Healthcare Common Procedure Coding System (HCPCS) Codes 87811 and 87428

CMS issued a new MLN Matters Article MM12093 on Addition of the QW Modifier to Healthcare Common Procedure Coding System (HCPCS) Codes 87811 and 87428 (PDF). Learn about updates to these laboratory tests.

2021 Annual Update to the Therapy Code List

CMS issued a new MLN Matters Article MM12126 on 2021 Annual Update to the Therapy Code List (PDF). Learn about additions, changes, and deletions.

Instructions to Medicare Administrative Contractors (MACs) on COVID-19 Emergency Declaration Blanket Waivers for Medicare-Dependent, Small Rural Hospitals and Sole Community Hospitals

CMS issued a new MLN Matters Article MM12070 on Instructions to Medicare Administrative Contractors (MACs) on COVID-19 Emergency Declaration Blanket Waivers for Medicare-Dependent, Small Rural Hospitals and Sole Community Hospitals (PDF). Learn about regulatory flexibilities.

Quarterly Update to Home Health (HH) Grouper

CMS issued a new MLN Matters Article MM12047 on Quarterly Update to Home Health (HH) Grouper (PDF). Learn about diagnosis code changes for COVID-19.

Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 27.1, Effective April 1, 2021

CMS issued a new MLN Matters Article MM12110 on Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 27.1, Effective April 1, 2021 (PDF). Learn about the new file.

Updating Calendar Year (CY) 2021 Medicare Diabetes Prevention Program (MDPP) Payment Rates

CMS issued a new MLN Matters Article MM12030 on Updating Calendar Year (CY) 2021 Medicare Diabetes Prevention Program (MDPP) Payment Rates (PDF). Learn about payment rates for 15 HCPCS G-codes.

Billing for Home Infusion Therapy Services on or After January 1, 2021 — Revised

CMS revised MLN Matters Article MM11880 on Billing for Home Infusion Therapy Services on or After January 1, 2021 (PDF) to add codes J1559 JB and J7799 JB.

Telehealth Expansion Benefit Enhancement under the Pennsylvania Rural Health Model (PARHM) – Implementation — Revised

CMS revised MLN Matters Article MM11870 on Telehealth Expansion Benefit Enhancement Under the Pennsylvania Rural Health Model (PARHM) - Implementation (PDF) to update denial edits.

Publications

Complying with Laboratory Services Documentation Requirements — Revised

CMS revised the Medicare Learning Network fact sheet, Complying with Laboratory Services Documentation Requirements. Learn about:

Documentation and signature requirements
Ordering or referring services

Multimedia

Enroll in Medicare to Administer COVID-19 Vaccine Shots: Information for Health Care Providers Video

CMS posted a new Medicare Learning Network video, Enroll in Medicare to Administer COVID-19 Vaccine Shots: Information for Health Care Providers. Learn about requirements, resources, and how to get ready if you are:

Already enrolled in Medicare
Not a Medicare provider

Hospital Price Transparency Webcast: Audio Recording & Transcript

An audio recording (ZIP), transcript (PDF), and clarification (PDF) are available for the December 8 Medicare Learning Network webcast on Hospital Price Transparency. Effective January 1, each hospital operating in the United States is required to provide clear, accessible pricing information online. Learn about resources to help you prepare for compliance.

Promoting Interoperability Listening Session: Audio Recording & Transcript

An audio recording (ZIP), transcript (PDF), and clarification (PDF) are available for the December 16 Medicare Learning Network listening session on the Improving Prior Authorization Processes and Promoting Patients’ Electronic Access to Health Information Proposed Rule. Learn about the proposed requirements.

Information for Medicare Patients

From Coverage to Care Resources Help Navigate Health Coverage

From Coverage to Care (C2C) resources help patients and communities learn how to understand their health coverage and connect to care. Download and share these resources:

Roadmap to Better Care and a Healthier You: Explains what health coverage is and how to use it to get primary care and preventive services
My Health Coverage at-a-Glance (PDF): Customizable resource for consumers that keeps information about their plan, what they pay for health care, and where to go – all on one page
5 Ways to Make the Most of Your Health Coverage (PDF): Outlines ways that consumers can put their health first and live a long and healthy life
2 COVID-19 resources explain what health services are typically covered under health plans

Most of our free resources are available in 8 languages. Find more on the C2C webpage, or contact CoveragetoCare@cms.hhs.gov.

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2021-01-07-MLNC

News

COVID-19 Vaccines: CDC Long-Term Care Facility Toolkit

MLN Web-Based Training: Complete Training & Save Certificates by January 31