Thursday, March 31, 2022
- Home Health Providers: Services Provided Data for April 2022 Refresh
- Continuous Glucose Monitor: Provide Supplies for a Calendar Month
- Cognitive Impairment: Medicare Provides Opportunities to Detect & Diagnose
- April 2022 Update of the Ambulatory Surgical Center (ASC) Payment System
- Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting & Reporting Data for the Private Payor Rate-Based Payment System — Revised
News
Home Health Providers: Services Provided Data for April 2022 Refresh
For the April 2022 refresh of the Care Compare webpage, CMS will re-publish home health agency services provided data from the January 2022 refresh. This will give us time to correct issues in your April 2022 Provider Preview Reports.
Visit the Updates section of the Quality Reporting Program Spotlight and Announcements webpage for more details, including:
- How to access your Provider Preview Report for April
- Reviewing your preview report
- How to get help
Continuous Glucose Monitor: Provide Supplies for a Calendar Month
We’ve heard from Medicare patients who have a continuous glucose monitor (CGM) that they’ve run out of testing supplies before the end of the month. These patients can’t get traditional testing supplies because they have a CGM.
For example, if a patient gets 2 (14-day) CGM sensors for April, the patient won’t have enough to test on the 29th and 30th.
Here’s how to prevent this serious issue:
- Bill the supply allowance (code K0553) as 1 unit of service (UOS) per month. One UOS equals 1 month’s supply (31, 30, 29, or 28 days). You can only bill 1 UOS for code K0553 per month.
- Check regularly to see what supplies your patient needs.
- Send these supplies to meet the next month’s supply need.
The example below shows how to provide 14-day CGM supplies per calendar month to make sure your patient has enough:
- April – 30 calendar days: Provide 3 sensors (42-day supply)
- May – 31 calendar days: Provide 2 sensors (28-day supply) since the patient should have 12 days remaining from the previous month
- June – 30 calendar days: Provide 2 sensors (28-day supply) since the patient should have 9 days remaining from the previous month
Review provider compliance tips on glucose monitors, diabetic accessories, & supplies.
Cognitive Impairment: Medicare Provides Opportunities to Detect & Diagnose
Do you have a patient with a cognitive impairment? Medicare covers a separate visit for a cognitive assessment, so you can more thoroughly evaluate cognitive function and help with care planning.
3 things you need to know:
- If your patient shows signs of cognitive impairment at an Annual Wellness Visit or other routine visit, you may perform a more detailed cognitive assessment and develop a care plan
- Cognitive Assessment & Care Plan Services (CPT code 99483) typically start with a 50-minute face-to-face visit that includes a detailed history and patient exam, resulting in a written care plan
- Any clinician eligible to report evaluation and management services can offer this service, including: physicians (MD and DO), nurse practitioners, clinical nurse specialists, and physician assistants
Effective January 1, 2022, Medicare pays approximately $283 (may be geographically adjusted) for these services when provided in an office setting.
Get details on Medicare coverage requirements and proper billing at cms.gov/cognitive.
Claims, Pricers, & Codes
Hospice Web Pricer
CMS released the Hospice Prospective Payment System Web Pricer for fiscal 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 Cost Report E-Filing System: Interim Rate & Settlement Documentation Webinar — April 26
Tuesday, April 26 from 1–2:30 pm ET
If you’re a Medicare Part A provider or organization that files cost reports, attend this webinar to learn about new functionality in the Medicare Cost Report E-Filing (MCReF) system:
- View and download interim rate review, tentative settlement, and final or reopening settlement documentation completed by your Medicare Administrative Contractor
- Submit individual or bulk (chain providers) Medicare Part A cost reports for fiscal years ending on or after December 31, 2017
- Track the status of Medicare Part A cost reports with fiscal years ending after December 31, 2009
Send questions in advance to OFMDPAOQuestions@cms.hhs.gov with “MCReF Webinar” in the subject line. We’ll answer your questions during the webinar or use them to develop educational materials.
More Information:
MLN Matters® Articles
April 2022 Update of the Ambulatory Surgical Center (ASC) Payment System
Learn about changes effective April 1, 2022 (PDF):
- Updates to calendar year 2022 payment rates for separately payable procedures, services, drugs, and biologicals
- Descriptors for new CPT and Level II HCPCS codes
Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting & Reporting Data for the Private Payor Rate-Based Payment System — Revised
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