Railroad Medicare Provider News for 12/5/2018

Summary of Policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List

Change Request (CR) 11063 provides a summary of policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule and announces the Telehealth Originating Site Facility Fee payment amount and makes other policy changes related to Medicare Part B payment. These changes are applicable to services furnished in CY 2019. Make sure your billing staffs are aware of these updates.

Ambulance Inflation Factor for Calendar Year 2019 and Productivity Adjustment

Change Request (CR) 11031 furnishes the Calendar Year (CY) 2019 Ambulance Inflation Factor (AIF) for determining the payment limit for ambulance services. The AIF for CY 2019 is 2.3 percent. Make sure that your billing staffs are aware of this change.


Want to get these updates automatically?

Sign up for our Daily Listerv or Subscribe to our RSS Feed

Jurisdiction M Home Health & Hospice News for 12/5/2018

Summary of Policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List

Change Request (CR) 11063 provides a summary of policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule and announces the Telehealth Originating Site Facility Fee payment amount and makes other policy changes related to Medicare Part B payment. These changes are applicable to services furnished in CY 2019. Make sure your billing staffs are aware of these updates.

Active Medical Reviews

This article provides a listing of active medical reviews being conducted by Palmetto GBA. Please share with appropriate staff.


Want to get these updates automatically?

Sign up for our Daily Listerv or Subscribe to our RSS Feed

Jurisdiction M Part B News for 12/5/2018

Summary of Policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List

Change Request (CR) 11063 provides a summary of policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule and announces the Telehealth Originating Site Facility Fee payment amount and makes other policy changes related to Medicare Part B payment. These changes are applicable to services furnished in CY 2019. Make sure your billing staffs are aware of these updates.

Ambulance Inflation Factor for Calendar Year 2019 and Productivity Adjustment

Change Request (CR) 11031 furnishes the Calendar Year (CY) 2019 Ambulance Inflation Factor (AIF) for determining the payment limit for ambulance services. The AIF for CY 2019 is 2.3 percent. Make sure that your billing staffs are aware of this change.

Active Medical Reviews

This article provides a listing of active medical reviews being conducted by Palmetto GBA. Please share with appropriate staff.


Want to get these updates automatically?

Sign up for our Daily Listerv or Subscribe to our RSS Feed

Jurisdiction M Part A News for 12/5/2018

Summary of Policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List

Change Request (CR) 11063 provides a summary of policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule and announces the Telehealth Originating Site Facility Fee payment amount and makes other policy changes related to Medicare Part B payment. These changes are applicable to services furnished in CY 2019. Make sure your billing staffs are aware of these updates.

Ambulance Inflation Factor for Calendar Year 2019 and Productivity Adjustment

Change Request (CR) 11031 furnishes the Calendar Year (CY) 2019 Ambulance Inflation Factor (AIF) for determining the payment limit for ambulance services. The AIF for CY 2019 is 2.3 percent. Make sure that your billing staffs are aware of this change.

Active Medical Reviews

This article provides a listing of active medical reviews being conducted by Palmetto GBA. Please share with appropriate staff.


Want to get these updates automatically?

Sign up for our Daily Listerv or Subscribe to our RSS Feed

Jurisdiction J Part B News for 12/5/2018

Summary of Policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List

Change Request (CR) 11063 provides a summary of policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule and announces the Telehealth Originating Site Facility Fee payment amount and makes other policy changes related to Medicare Part B payment. These changes are applicable to services furnished in CY 2019. Make sure your billing staffs are aware of these updates.

Ambulance Inflation Factor for Calendar Year 2019 and Productivity Adjustment

Change Request (CR) 11031 furnishes the Calendar Year (CY) 2019 Ambulance Inflation Factor (AIF) for determining the payment limit for ambulance services. The AIF for CY 2019 is 2.3 percent. Make sure that your billing staffs are aware of this change.


Want to get these updates automatically?

Sign up for our Daily Listerv or Subscribe to our RSS Feed

Jurisdiction J Part A News for 12/5/2018

Summary of Policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List

Change Request (CR) 11063 provides a summary of policies in the Calendar Year (CY) 2019 Medicare Physician Fee Schedule (MPFS) Final Rule and announces the Telehealth Originating Site Facility Fee payment amount and makes other policy changes related to Medicare Part B payment. These changes are applicable to services furnished in CY 2019. Make sure your billing staffs are aware of these updates.

Ambulance Inflation Factor for Calendar Year 2019 and Productivity Adjustment

Change Request (CR) 11031 furnishes the Calendar Year (CY) 2019 Ambulance Inflation Factor (AIF) for determining the payment limit for ambulance services. The AIF for CY 2019 is 2.3 percent. Make sure that your billing staffs are aware of this change.


Want to get these updates automatically?

Sign up for our Daily Listerv or Subscribe to our RSS Feed

Jurisdiction M Home Health & Hospice News for 12/3/2018

Targeted Probe and Educate Progress Update

The Centers for Medicare & Medicaid Services (CMS) Change Request 10249 implemented the Targeted Probe & Educate (TPE) process, effective October 1, 2017. Medical Review initiated Probe review edits for providers identified through data analysis demonstrating high risk for improper payment. Providers have been offered education throughout and upon completion of the Probe 1 TPE review. Please review and share with your staff.

October 4, 2018, Hospice Coalition Questions and Answers

The October 4, 2018, Hospice Coalition Questions and Answers are now available. Please review and share this information with your staff.


Want to get these updates automatically?

Sign up for our Daily Listerv or Subscribe to our RSS Feed

Jurisdiction M Part B News for 12/3/2018

Local Coverage Determination (LCD) Updates Part B

The Assays for Vitamins and Metabolic Function L33418 Part B Local Coverage Determination (LCD) was revised. Please share this with your staff.

Medicare Coverage of Echocardiography

Palmetto GBA identified Transthoracic Echocardiography (TTE) services as an area of vulnerability. Palmetto GBA’s Local Coverage Determination, L37379 – Echocardiography, addresses the medically necessary and appropriate application of TTE. Please share with appropriate staff.

DME: Medicare Enrollment for Providers Who Solely Order or Certify

The DME MACs have identified a significant number of claims rejected due to issues with the National Provider Identifier (NPI). Take time to review the MLN Fact Sheet on Medicare Enrollment For Providers Who Solely Order or Certify to assist with understanding NPI issues causing these rejections. Please review this information and share it with your staff.

Important Update: The Medicare Prior Authorization Model for Repetitive Scheduled, Non-Emergent Ambulance Transport Has Been Extended One Year

The Medicare Repetitive Scheduled Non-Emergent Ambulance Transport Prior Authorization Model in the states of New Jersey, Pennsylvania, Maryland, Delaware, the District of Columbia, North Carolina, South Carolina, Virginia and West Virginia has been extended one additional year through December 1, 2019, based on date of service. Please share this information with your staff.


Want to get these updates automatically?

Sign up for our Daily Listerv or Subscribe to our RSS Feed

Jurisdiction M Part A News for 12/3/2018

Ask the Contractor Teleconference (ACT): Intensity Modulated Radiation Therapy (IMRT) Planning Services: November 13, 2018

The questions and answers from the November 13, 2018, Ask the Contractor Teleconference (ACT) are now available. Please review and share with your staff.

Calculation of the Transitional Drug Add-on Payment Adjustment (TDAPA) and Outlier

Palmetto GBA will mass adjust ESRD 72X TOB claims. Please share this update with your staff.


Want to get these updates automatically?

Sign up for our Daily Listerv or Subscribe to our RSS Feed

Jurisdiction J Part B News for 12/3/2018

Medicare Coverage of Echocardiography

Palmetto GBA identified Transthoracic Echocardiography (TTE) services as an area of vulnerability. Palmetto GBA’s Local Coverage Determination, L37379 – Echocardiography, addresses the medically necessary and appropriate application of TTE. Please share with appropriate staff.

DME: Medicare Enrollment for Providers Who Solely Order or Certify

The DME MACs have identified a significant number of claims rejected due to issues with the National Provider Identifier (NPI). Take time to review the MLN Fact Sheet on Medicare Enrollment For Providers Who Solely Order or Certify to assist with understanding NPI issues causing these rejections. Please review this information and share it with your staff.


Want to get these updates automatically?

Sign up for our Daily Listerv or Subscribe to our RSS Feed