Railroad Medicare Provider News for 10/18/2018

Updating Calendar Year (CY) 2019 Medicare Diabetes Prevention Program (MDPP) Payment Rates

Change Request (CR) 10970 contains instructions for Medicare Administrative Contractors (MACs) and the Railroad Specialty MAC to update the Medicare Diabetes Prevention Program (MDPP) Expanded Model payment rates for calendar year (CY) 2019. Make sure your billing staffs are aware of the update.


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Jurisdiction M Home Health & Hospice News for 10/18/2018

Review Choice Demonstration (RCD) Presentation for the 2018 NAHC

This is Palmetto GBA’s Review Choice Demonstration (RCD) slide show presentation from the 2018 National Association for Home Care and Hospice Conference in Grapevine, TX. Please review this presentation and share it with your staff.


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This post applies to: JM HHH

Jurisdiction M Part B News for 10/18/2018

Updating Calendar Year (CY) 2019 Medicare Diabetes Prevention Program (MDPP) Payment Rates

Change Request (CR) 10970 contains instructions for Medicare Administrative Contractors (MACs) and the Railroad Specialty MAC to update the Medicare Diabetes Prevention Program (MDPP) Expanded Model payment rates for calendar year (CY) 2019. Make sure your billing staffs are aware of the update.


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Jurisdiction J Part B News for 10/18/2018

Procedure Codes that Require Additional Documentation

The submission of additional documentation is required only when certain CPT/HCPCS codes are billed or when additional documentation is needed for Palmetto GBA to process and or price a service. This article has been updated to include an additional modifier in which additional documentation should be submitted. The article also includes a note regarding claim rejection reason and remark codes where additional documentation is needed. Please share with appropriate staff.

Updating Calendar Year (CY) 2019 Medicare Diabetes Prevention Program (MDPP) Payment Rates

Change Request (CR) 10970 contains instructions for Medicare Administrative Contractors (MACs) and the Railroad Specialty MAC to update the Medicare Diabetes Prevention Program (MDPP) Expanded Model payment rates for calendar year (CY) 2019. Make sure your billing staffs are aware of the update.


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Jurisdiction M Home Health & Hospice News for 10/16/2018

Key Points to Changes to the Hospice Eligibility Data Implemented with the July 2018 Quarterly Systems Release

On June 7, 2018, CMS released MLN Matters SE18007 that described system changes that would be implemented with the July 2018 quarterly systems release for hospice providers. The system changes apply to dates of service on or after June 1, 2018, and impact the way hospices are able to view a patient’s eligibility records through the Health Insurance Query Access (HIQA) screen in the Direct Data Entry (DDE) system. Hospice providers should note that the system will no longer post the Notice of Election (NOE), Type of Bill (TOB) 8XA, under the hospice benefit period screen in HIQA. Please review this article and share it with your staff.


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This post applies to: JM HHH