Thursday, March 17, 2022
- Medicare Shared Savings Program: Application Deadlines for January 1, 2023, Start Date
- Kidney Health: Help Address Disparities
- April 2022 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
- Federally Qualified Health Centers: Retroactive Claims Adjustments
- Home Health Web Pricer
- Complying with Medicare Signature Requirements — Revised
- Medicare Preventive Services — Revised
- SBIRT Services — Revised
News
Medicare Shared Savings Program: Application Deadlines for January 1, 2023, Start Date
Accountable Care Organizations: Visit the Application Types & Timeline webpage to learn about participating in the Medicare Shared Savings Program that starts January 1. Key dates:
- June 1–7: Submit Notice of Intent to Apply (NOIA) (PDF) — You must submit a NOIA if you plan to apply, but it doesn’t commit your organization to apply
- June 8–June 29: Submit application
More Information:
- Medicare Shared Savings Program webpage
- Send questions to SharedSavingsProgram@cms.hhs.gov
Kidney Health: Help Address Disparities
About 15% of adults have chronic kidney disease. It’s most common in Medicare patients and disproportionately affects Black, American Indian/Alaskan Native, and Hispanic patients. During National Kidney Month, learn about preventive services, and find out how to advance health equity.
Medicare covers preventive services for the 2 most common causes of chronic kidney disease: diabetes and high blood pressure. Your patients pay nothing if you accept assignment.
More Information:
- Medicare Preventive Services educational tool
- CMS Office of Minority Health, Health Observances webpage
- Preventive & Screening Services webpage: Get information for your patients
Claims, Pricers, & Codes
April 2022 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
Learn about quarterly updates to the following pricing files, effective for the dates of service listed below:
- April 1–June 30, 2022: April 2022 ASP and ASP Not Otherwise Classified (NOC)
- January 1–March 31, 2022: January 2022 ASP and ASP NOC
- October 1–December 31, 2021: October 2021 ASP and ASP NOC
- July 1–September 30, 2021: July 2021 ASP and ASP NOC
- April 1–June 30, 2021: April 2021 ASP and ASP NOC
See the instruction to your Medicare Administrative Contractor (PDF).
Federally Qualified Health Centers: Retroactive Claims Adjustments
Medicare Administrative Contractors will adjust all Federally Qualified Health Center (FQHC) claims with dates of service from January 1, 2022, until the corrected calendar year 2022 FQHC geographic adjustment factors table is implemented about March 25. You don’t need to do anything.
Home Health Web Pricer
CMS released the Home Health Prospective Payment System Web Pricer for calendar years 2020–2022. For the best experience, access the Web Pricer through Google Chrome. You may also use Microsoft Edge or Mozilla Firefox but not Microsoft Internet Explorer.
Events
Medicare Ground Ambulance Data Collection System: Q&A Session — March 29
Tuesday, March 29 from 2–3pm 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 “March 29 Q&A” in the subject line. We’ll update documents 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 and report information starting in 2023
- Calendar Year (CY) 2022 Physician Fee Schedule (PFS) final rule
- CY 2020 PFS final rule
- Bipartisan Budget Act of 2018
- Quick Reference Guide (PDF): updated March 8
- Medicare Ground Ambulance Data Collection Instrument (English (PDF), Spanish (PDF))
- FAQs (PDF)
MLN Matters® Articles
April 2022 Update to the Fiscal Year (FY) 2022 Inpatient Prospective Payment System (IPPS)
Learn about coding for Pfizer's PAXLOVID™ and Merck’s Molnupiravir (PDF).
Publications
Complying with Medicare Signature Requirements — Revised
Learn about signing documents electronically when you provide or certify services (PDF).
Medicare Preventive Services — Revised
Learn about changes for lung cancer screening, effective February 10, 2022:
- Lowered the screening age from 55 to 50
- Lowered tobacco smoking history from at least 30 pack-years to 20
- Expanded screening with low dose computed tomography
SBIRT Services — Revised
Learn about screening, brief intervention, & referral to treatment (SBIRT) services covered by Medicare and Medicaid (PDF). Beginning January 1, 2022, we cover Naloxone, HCPCS Code G1028.
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