Tag: billing

CMS creates resource page for hospice VBID

CMS has created a special online resource page for the hospice Value-Based Insurance Design (VBID) demo. This page relays key information related to the model, including: an overview, coverage information, participating plans, billing and payment information, outreach and education and frequently asked questions. CMS is testing the inclusion of the Part A Hospice Benefit within […]

CMS clarifies RAP submission billing rules

CMS revised change request (CR) 11855 clarifying rules around the 5-day RAP submission requirement need to prevent payment delays starting in January. The article details how to document situations in which a date could not be entered on line 0023 because the first visit did not occur within the first five days of the period. […]

Homecare for Seniors Act introduced, would allow tax-exempt distributions from HSAs for qualified home care

A recently proposed bill would allow tax-exempt distributions from health savings accounts (HSAs) to be used for qualified home care. The Homecare for Seniors Act was introduced in the Senate on Feb. 10. It specifies that under qualified home care a contract would offer three or more services for the service recipient, according to the bill. Services […]

Special requirements for billing urology supplies & updated DMEPOS fee schedule

Source: The Bottom Line Medicare covers urinary catheters and external urinary collection devices when they are used to drain or collect urine for a resident with permanent urinary incontinence or permanent urinary retention. According to CMS, permanent urinary retention occurs when the condition is not expected to be medically or surgically corrected within three months. […]

CMS releases updates to billing for flu vaccine

by The Bottom Line Flu season is August to April. Make sure you’re prepared to start billing for the influenza virus vaccine by staying up to date on the latest code and payment allowance updates. So far, CMS has released the following two notices: 1. Payment allowances for the influenza virus vaccine are updated on […]

Avoid Medicaid payment delays by being proactive

Written by Becky Ziviski, CPA, LNHA, speaker and author of Profit Without Census: A Nursing Home Administrator’s Guide to Profitability by Department. Editor’s note: This post is an excerpt taken from the full article originally published in the August issue of PPS Alert for Long-Term Care. A delay in the application process for Medicaid can […]

CMS scrutiny of updates to Part B therapy coding to begin January 2018

In a recent MLN Matters article, the Centers for Medicare & Medicaid Services (CMS) published revisions to editing of Part B “Always Therapy” services, identifying outpatient therapy (OPT) services that must always be accompanied by a discipline-specific therapy modifier. CMS states that Change Request (CR) 10176, intended for therapists, physicians, and certain other practitioners billing […]

Home health device provider to pay for improper billing

Apria Healthcare, which makes home healthcare devices, has been ordered to pay $750,000 to resolve obligations that they billed patients that were already covered by MassHealth, Massachusetts’ state insurance program. The State Attorney General’s office told WWLP.com that between December of 2011 and April of 2017, some 1,000 MassHealth members were inappropriately billed, and of […]

In the end, even the middle class would feel GOP cuts to nursing home care

By Jordan Rau, Kaiser Health News ORANGE, Va. — Alice Jacobs, 90, once owned a factory and horses. She raised four children and buried two husbands. But years in an assisted living facility drained her savings, and now she relies on Medicaid to pay for her care at Dogwood Village, a nonprofit, county-owned nursing home […]

CMS welcomes feedback on proposed case-mix rule, extends comment deadline

The Centers for Medicare & Medicaid Services (CMS) has extended the comment deadline for the advance notice of proposed revisions to case-mix methodology rule from June 26, 2017 to August 25, 2017. The advance notice of proposed rulemaking, titled “Prospective Payment System and Consolidated Billing for Skilled Nursing Facilities: Revisions to Case-mix Methodology,” was published […]