There are several changes coming to Medicare benefits for 2021: Every year, a cost-of-living adjustment (COLA) is announced. In 2020, benefits increased by 1.6% and for 2021, benefits will increase by 1.3%. This will result in an average increase of about $20 per month. The Medicare cost increases for 2021 are as follows The standard […]
Gastroenterology Billing Compliance: Enteral Infusion Pumps
The Centers for Medicare & Medicaid Services (CMS) has released a video that contains guidance to help providers bill correctly for enteral infusion pumps. Medicare Part B covers enteral nutrition supplies and equipment (feeding pump) under the prosthetic device benefit. The two-minute video discusses Medicare coverage criteria for enteral infusion pumps and the four pieces […]
Medicare Releases 2017 Ambulatory Surgery Center Payment Final Rule
The Centers for Medicare & Medicaid Services recently released its 2017 ambulatory surgery center (ASC) payment final rule. There were a few changes worth noting, according to the national ASC Association (ASCA). 1. Payment increase. ASC payment rates will increase by 1.9%, which is larger than the 1.2% identified in the proposed rule. 2. Procedures […]
CMS Releases Laboratory Billing Compliance Fact Sheet
The Centers for Medicare & Medicaid Services (CMS) has released a new provider compliance fact sheet concerning laboratory medical billing. The fact sheet noted that a HHS report revealed “laboratory tests – other” (e.g., urine drug screening, medication assays, genetic tests, tissues examination, blood tests) had an improper payment rate of 39 percent, with a […]
CMS Issues Reminder About Reporting Medicare Enrollment Changes
The Centers for Medicare & Medicaid Services (CMS) has issued a reminder to Medicare-enrolled providers concerning reporting changes in enrollment information. Failure to comply with the requirements to report changes in Medicare enrollment information could result in the revocation of Medicare billing privileges. All physicians, non-physician practitioners (e.g., physician assistants, nurse practitioners, clinical nurse specialists, […]
CMS Provides Clarification on the Use of Modifiers When Billing “Wrong Surgery on a Patient”
The Centers for Medicare and Medicaid Services (CMS) recently released a Medicare Learning Network podcast which was intended to clarify the correct use of certain HCPCS modifiers, specifically when billing for wrong surgery on a patient. CMS discussed the HCPCS modifier -PC (Wrong Surgery on Patient), which was established in CR6405 (pdf), along with two […]
American Chiropractic Association Publishes New PQRS Reporting Resources
The American Chiropractic Association (ACA) has published several new resources intended to help doctors of chiropractic (DCs) with proper implementation of Medicare’s Physician Quality Reporting System (PQRS). Eligible professionals who do not satisfactorily report data on quality measures for covered professional services will be subject to a PQRS negative payment adjustment (pdf) beginning in 2015. […]