Tag: billing

Hospices face new requirement for transfers

CMS is introducing new billing instructions when a hospice is involved in a patient transfer. Currently, transfers are being allowed to process through the Common Working File (CWF) with a “from date” from the receiving hospice that doesn’t match the “to date” from the transferring hospice. “We consider any gap, even of one day, to […]

New vaccine billing process begins for MA patients

When billing for the COVID-19 vaccine for patients enrolled in Medicare Advantage, agencies should be submitting the claims to the MA plan, as Original Medicare is no longer paying these claims in 2022. CMS issued its latest reminder on this in the January 6, 2022, MLN newsletter. According to an alert by MAC Palmetto GBA, […]

CMS: Pay attention to telehealth billing rules

CMS is reminding providers to ensure that Medicare claims for telehealth are correctly billed. The agency issued broadly expanded telehealth services as part of its response to the COVID-19 public health emergency. However, a 2018 Office of Inspector General audit found that CMS paid practitioners for some telehealth claims that did not meet Medicare requirements […]

CMS offers billing instructions for COVID-19 vaccine administration

CMS has released information on Medicare billing for COVID-19 vaccine shot administration. Here are some things to keep in mind from CMS: You’ll be able to bill on single claims for COVID-19 shot administration or submit claims on a roster bill for multiple patients at one time. When COVID-19 vaccine doses are provided by the […]

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 […]