Thursday, August 19, 2021
- Medicare Ground Ambulance Data Collection System: Instrument Walkthrough Webinar — August 26
- Medicare Ground Ambulance Data Collection System: Q&A Session — September 14
- Implementation of the Capital Related Assets Adjustment (CRA) for the Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) Under the End Stage Renal Disease Prospective Payment System (ESRD PPS)
- Implementation of the GV Modifier for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) for Billing Hospice Attending Physician Services
- Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Updates for Fiscal Year (FY) 2022
- Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2022
- Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2022
- Modifications/Improvements to Value-Based Insurance Design (VBID) Model – Implementation
- Skilled Nursing Facility (SNF) Claims Processing Updates
- Update of Internet Only Manual (IOM), Pub. 100-04, Chapter 8 - Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims
View this edition as PDF (PDF)
News
Immunization: Medicare Covers Vaccines
Medicare covers the following vaccines:
- COVID-19: See provider toolkit for enrollment, payment, coding, and billing
- Influenza: See flu shot frequency, coverage, payment, coding, and billing
- Pneumococcal: An initial shot and a different, second shot per pneumococcal vaccine recommendations
- Hepatitis B: For certain patients at intermediate or high risk
Many Medicare patients missed vaccines during the pandemic. During National Immunization Awareness Month (NIAM), encourage your patients to get back on track with routine vaccines:
- Help protect your patients against serious disease. Talk to your patients about vaccines they may have missed.
- Help high-risk patients learn about the benefits of vaccines.
- Your recommendation can make a difference. You’re a valued and trusted source of health information.
- Even if your practice doesn’t administer or stock certain vaccines, refer patients to other vaccine providers and follow up.
More Information:
- Preventive Services webpage
- CDC NIAM and Adult Vaccination Resources webpages
- Office of Minority Health webpage: Resources for minority and underserved patients
- Vaccines.gov
- Part D Vaccines (PDF) fact sheet
- Information for your patients on COVID-19 vaccine, flu shots, pneumococcal shots, and Hepatitis B shots
Compliance
Chiropractic Services: Comply with Medicare Billing Requirements
An Office of Inspector General report found that payments for chiropractic services didn’t comply with Medicare billing requirements. Medical record documentation didn’t support medical necessity or corrective treatment. Review the Medicare Documentation Job Aid for Doctors of Chiropractic (PDF) educational tool to help you bill correctly.
More information:
- Medicare Benefit Policy Manual, Chapter 15 (PDF), Sections 30.5 and 240
- Medicare Claims Processing Manual, Chapter 12 (PDF), Section 220
Events
Medicare Ground Ambulance Data Collection System: Instrument Walkthrough Webinar — August 26
Thursday, August 26 from 2-3:30 pm ET
Learn about the Medicare Ground Ambulance Data Collection Instrument section-by-section, including:
- Selected instructions
- Data collection guidelines
- FAQs
- Proposed changes in the Calendar Year (CY) 2022 Physician Fee Schedule proposed rule
A Q&A session follows this presentation. You may also send questions in advance to AmbulanceDataCollection@cms.hhs.gov with “August 26 Instrument Webinar” in the subject line.
More Information:
- Presentation (PDF)
- Ambulances Services Center webpage: Includes ground ambulance organizations that must collect data starting in 2022
- CY 2020 Physician Fee Schedule final rule
- Bipartisan Budget Act of 2018
Medicare Ground Ambulance Data Collection System: Q&A Session — September 14
Tuesday, September 14 from 2-3 pm ET
Do you have questions about the Medicare Ground Ambulance Data Collection System? Join this live Q&A session. You may also send questions in advance to AmbulanceDataCollection@cms.hhs.gov with “September 14 Q&A” in the subject line. We’ll update documents on our Ambulances Services Center webpage with answers to common questions from this session.
More Information:
- Ambulances Services Center webpage: Includes lists of organizations that must collect data starting in 2022
- Calendar Year (CY) 2022 Physician Fee Schedule (PFS) proposed rule
- CY 2020 PFS final rule
MLN Matters® Articles
Implementation of the Capital Related Assets Adjustment (CRA) for the Transitional Add-on Payment Adjustment for New and Innovative Equipment and Supplies (TPNIES) Under the End Stage Renal Disease Prospective Payment System (ESRD PPS)
ESRD: Learn about the AX modifier and relevant revenue codes (PDF).
Implementation of the GV Modifier for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) for Billing Hospice Attending Physician Services
RHCs and FQHCs: Learn about the modifier (PDF).
Inpatient Psychiatric Facilities Prospective Payment System (IPF PPS) Updates for Fiscal Year (FY) 2022
Learn about changes to discharges starting October 1 (PDF).
Inpatient Rehabilitation Facility (IRF) Annual Update: Prospective Payment System (PPS) Pricer Changes for FY 2022
Learn about rate updates for discharges starting October 1 (PDF).
Medicare Part A Skilled Nursing Facility (SNF) Prospective Payment System (PPS) Pricer Update FY 2022
Learn about updates to the payment rates (PDF).
Modifications/Improvements to Value-Based Insurance Design (VBID) Model – Implementation
Learn about the Hospice Benefit Component (PDF).
Skilled Nursing Facility (SNF) Claims Processing Updates
- Services related to an emergency room encounter when there is a revenue code of 250 on the same claim
- Overlapping claims when there is a no-pay hospital claim during an interrupted stay
Update of Internet Only Manual (IOM), Pub. 100-04, Chapter 8 - Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims
Learn about key revisions (PDF).
Publications
IRF & LTCH: Q&A Basics
CMS offers an instructional resource (PDF) for Inpatient Rehabilitation Facility (IRF) and Long-Term Care Hospital (LTCH) providers on how to access and use quarterly Q&A documents for the Quality Reporting Program (QRP):
- Purpose and benefits
- Setting-specific documents
- Release dates
More Information:
- IRF QRP Training webpage
- LTCH QRP Training webpage
Multimedia
Medicare Fraud & Abuse: Prevent, Detect, Report Web-Based Training — Revised
See updated information in this Medicare Learning Network (MLN) web-based training course:
- How to identify and report
- Provisions and penalties
- Prevention methods
Visit the MLN Web-Based Training webpage for a current list of courses.
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