Thursday, January 11, 2024
- Marriage and Family Therapist & Mental Health Counselor Services: Overpayments to Critical Access Hospitals Billing under Method II
- Medicare Part A Cost Report Exhibits: New Electronic Templates
- Additional Residency Positions: Apply by March 31
- Therapy Services: Per-Beneficiary CY 2024 Threshold Amounts
- COVID-19 Vaccine CY 2024 Geographically-Adjusted Payment Rates
- Medicare Diabetes Prevention Program: CY 2024 Payment Rates
- Ambulance Fee Schedule: CY 2024 Inflation Factor
- Medicare Wellness Visits: Healthy Start to 2024
News
Marriage and Family Therapist & Mental Health Counselor Services: Overpayments to Critical Access Hospitals Billing under Method II
CMS is working to implement payment edits for marriage and family therapist (MFT) and mental health counselor (MHC) services that are furnished in critical access hospitals (CAHs) and billed under CAH method II. These payment edits will establish the statutorily mandated payment rates applicable to MFT and MHC furnished services. We plan to complete the payment edits during the second quarter of 2024. In the interim, we’ll pay CAH method II claims for MFT and MHC services for dates of service starting January 1, 2024, at the Medicare Physician Fee Schedule rate.
We’ll correct this overpayment by July 1, 2024, and your Medicare Administrative Contractor will automatically reprocess your claims. You don’t need to take any action.
Medicare Part A Cost Report Exhibits: New Electronic Templates
CMS published electronic cost report exhibit templates for the Medicare Cost Report e-Filing (MCReF) system.
- Get new exhibit templates, and learn how to use them:
- Medicare bad debt listing
- Medicaid eligible days
- Charity care charges
- Total bad debt
- Use the templates in the MCReF system to get immediate feedback about potential issues, along with faster acceptance and tentative settlement
For an overview of the exhibit templates, see slide 10–19 from the March 2023 (PDF) webinar.
Additional Residency Positions: Apply by March 31
You can apply for additional residency positions under Section 126 of the Consolidated Appropriations Act, 2021. Submit FY 2025 round 3 applications by March 31, 2024.
Visit Direct Graduate Medical Education, and scroll to Section 126: Distribution of Additional Residency Positions. Resources include:
Therapy Services: Per-Beneficiary CY 2024 Threshold Amounts
The CY 2024 KX modifier threshold amounts are:
- $2,330 for physical therapy and speech-language pathology services combined
- $2,330 for occupational therapy services
More Information:
- Therapy Services webpage, including CY 2024:
- Instruction to your Medicare Administrative Contractor (PDF)
COVID-19 Vaccine CY 2024 Geographically-Adjusted Payment Rates
Get CY 2024 geographically-adjusted payment rates (ZIP) for COVID-19 vaccine administration, including additional payment rates for administering the vaccine in the patient’s home. Visit Vaccine Pricing for more information.
Medicare Diabetes Prevention Program: CY 2024 Payment Rates
Get CY 2024 payment rates (PDF) for the Medicare Diabetes Prevention Program.
See the instruction to your Medicare Administrative Contractor (PDF).
Ambulance Fee Schedule: CY 2024 Inflation Factor
The CY 2024 Ambulance Inflation Factor is 2.6%.
More Information:
- Section 20.4 Medicare Claims Processing Manual, Chapter 15 (PDF)
- Instruction to your Medicare Administrative Contractor (PDF)
Medicare Wellness Visits: Healthy Start to 2024
The new year is the perfect time to get your patients off to a healthy start by recommending Medicare wellness visits. We cover 2 types of exams:
- Initial preventive physical exam (IPPE) – one-time visit for patients new to Medicare within 12 months of first Part B coverage period
- Annual wellness visit (AWV) – covered for patients who:
- Aren’t within 12 months after their first Part B coverage period’s effective date
- Haven’t had an IPPE or AWV within the past 12 months
Your patients pay nothing for the visit if you accept assignment. However, your patients may have to pay coinsurance and the Part B deductible if you perform additional tests or services during the same visit that we don’t cover under the preventive benefit.
Find out when your patient is eligible for these exams. If you need help, contact your eligibility service provider.
Get information for your patients on the “Welcome to Medicare” preventive visit and Yearly “Wellness” visits.
Claims, Pricers, & Codes
Therapy Code List: 2024 Annual Update
CMS updated the list of codes (ZIP) that sometimes or always describe therapy services and also updated Disposition #10.
More Information:
Events
Medicare Ground Ambulance Data Collection System Overview Webinar — January 18
Thursday, January 18 from 2–3:30 pm ET
Register for this webinar. While everyone is welcome to participate, this session will be most relevant to selected ground ambulance organizations in Years 3 and 4 as they start reporting Medicare Ground Ambulance Data Collection System (GADCS) data to CMS in 2024.
This 60-minute presentation will cover all aspects of the GADCS, including:
- Overview and key concepts
- Section walkthrough
- User accounts, logging in, and linking to your organization
- Submitting and certifying your data
A Q&A session will follow the presentation.
More Information:
- Ambulance Events webpage: January 18 presentation will be posted here
- Medicare Ground Ambulance Data Collection System webpage:
- Printable version of the GADCS instrument in English and Spanish
- GADCS User Guide
- Tip sheets on reporting and getting access, FAQs, and prior educational sessions
- Lists of ground ambulance organizations required to participate in Years 1–4
From Our Federal Partners
Health Care Preparedness Resources
The Administration for Strategic Preparedness and Response's Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) released new health care preparedness resources:
- Utility Failures in Health Care Toolkit: tip sheets to help planners and facility managers identify issues to consider when planning for and responding to electrical, fuel, oxygen, telecommunications and information technology, and water outages
- The Exchange Issue 18: Innovations in Health Care Surge Capacity Management: interviews with health care facilities and systems discussing lessons learned about managing patient surge, load balancing, and transfer
- Lessons Learned from the Signature Healthcare Brockton Hospital Fire: webinar recording featuring hospital representatives sharing their experience navigating a complete utilities failure during a fire emergency and maintaining patient and staff safety
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