Home Health LUPA Threshold: Bill Correctly

• 07/06/2021
• Posted By: John Aldover

Home Health LUPA Threshold: Bill Correctly In a recent report, the Office of Inspector General found that Medicare improperly paid some claims for home health services with 5 to 7 visits in a payment episode. Review the Medicare Home Health Benefit and Home Health Prospective Payment System booklets to...

MACs Resume Medical Review on a Post-payment Basis

• 04/06/2021
• Posted By: John Aldover

MACs Resume Medical Review on a Post-payment Basis Beginning August 2020, Medicare Administrative Contractors (MACs) resumed post-payment reviews of items and services with dates of service before March 2020. MACs may now begin conducting post-payment medical reviews for later dates of service. The Targeted Probe and Educate program (intensive...

Critical Care Evaluation & Management Services: Comparative Billing Report in May

• 27/05/2021
• Posted By: John Aldover

Critical Care Evaluation & Management Services: Comparative Billing Report in May   In late May, CMS will issue a second letter in the Special Edition Comparative Billing Report (CBR) series on Part B claims for critical care evaluation & management services. Use the data-driven tables to compare your billing...

Save the Date! 2021 Home Health and Hospice Medicare Summit: 9/15, 9/16, and 9/17

• 29/04/2021
• Posted By: John Aldover

Save the Date! 2021 Home Health and Hospice Medicare Summit: 9/15, 9/16, and 9/17 Please plan on joining NGS, CGS & Palmetto GBA this year for a virtual Home Health and Hospice summit. The 2021 Home Health and Hospice Medicare Summit, Operation Collaboration: We Are All in This Together...

COVID-19 Vaccine and Monoclonal Antibody Billing for Home Health and Hospice Providers

• 28/04/2021
• Posted By: John Aldover

COVID-19 Vaccine and Monoclonal Antibody Billing for Home Health and Hospice Providers   This article will assist Medicare Home Health and Hospice providers with proper billing relating to COVID-19 vaccine and monoclonal antibody infusion. Beneficiary coinsurance and deductible are waived. How to Bill for COVID-19 Vaccines and Monoclonal Antibodies...

CMS Proposes to Enhance the Medical Workforce in Rural and Underserved Communities to Support COVID-19 Recovery and Beyond

• 28/04/2021
• Posted By: John Aldover

CMS Proposes to Enhance the Medical Workforce in Rural and Underserved Communities to Support COVID-19 Recovery and Beyond Proposed rule would require hospitals to report vaccination rates among health care staff On April 27, CMS issued a proposed rule (CMS-1752-P) for inpatient and long-term care hospitals that builds on...

4 Proposed FY 2020 Payment Rules

• 08/04/2021
• Posted By: John Aldover

Temporary Claims Hold

• 01/04/2021
• Posted By: John Aldover

Temporary Claims Hold Author: Michael Tidd LVN, HCS-D, COS-C CMS has directed al Medicare Administrative Contracts (MACs) to hold all claims with dates of service on or after April 1, 2021.  This is an action to avoid withholdings from claims related to the Sequestration Moratorium Extension passed by congress...