2024 Articles

HCPCS G2211 Bundle Beginning with dates of service September 1, 2024, UHC will begin to bundle G2211 and deny separate reimbursement. The provider announcement from UHC is linked below. https://www.uhcprovider....

UHC Home Health Service Changes Are you aware of the changes coming for providers of Home Health Services for United Healthcare patients? The link to the revised policy is below. https://www.uhcprovider.com/conte...

Diabetic Patient Management Are you aware of the changes coming to the management of your diabetic patients? Medicare has implemented changes effective October 7, 2024. The final rule is linked below. http...

Physician Fee Schedule Look-Up Tool The Centers for Medicare and Medicaid Services (CMS) has updated the online look-up tool to include physician updates for multiple years. https://www.cms.gov/medicare/physician-fee-schedule/search ...

Modifier TB As of 1/01/2025, modifier TB will be required by Medicare for providers who bill separately Part B drugs and participate in the 340B Drug Pricing Program. Additional information can be found in the MLN Fact Sheet MLN4800856...

Mental Health Coverage for Medicare Patients Have questions on what your patient's mental health benefits through Medicare are? Check out this MLN titled Medicare and Mental Health Coverage.   MLN 1986542 ...

New providers eligible to bill Medicare As of January 1, 2024 Marriage and Family Therapists and Mental Health Counselors are eligible to bill Medicare for services rendered. CMS has published an article answering some frequently asked questi...

Medicare Overpayments The attached article from CMS explains the changes coming July 1, 2024, regarding Medicare Overpayments. https://www.cms.gov/files/document/mm11808-limitation-recoupment-medicare-overpayments.pdf ...

HCPCS Code G2211 Do you know the ins and outs of billing this new HCPCS code? Check out this article from CMS for details: https://www.cms.gov/files/document/mm13473-how-use-office-and-outpatient-evaluation-and-management-vis...

COVID-19 Vaccine post PHE Looking for COVID-19 vaccine billing information post the Public Health Emergency (PHE)? Here is the latest from CMS: https://www.cms.gov/medicare/payment/covid-19/medicare-covid-19-vaccine-shot-payment#Home ...

New Provider Types and Taxonomy Codes The Centers for Medicare and Medicaid Services (CMS) has created 2 new provider types and associated taxonomy codes as of January 1, 2024. They include: Marriage & Family Therapist Taxono...

Medicare Fee Schedule Final Rule CY2024 Medicare has published a summary of the changes forthcoming for CY2024. They have made changes to: Telehealth services E/M visits Behavioral health services Dental and oral health servi...

CPT 2024 Each year, the American Medical Association (AMA) releases new and revised codes that reflect what is happening in medicine and in response to feedback received from medical providers. New technology, new viruses/illnesses, an...

The Centers for Medicare and Medicaid Services (CMS) released the final rule on the CY 2024 physician fee schedule on November 2, 2023. Details are included in the article linked below. https://www.cms.gov/newsroom/fact-sheets/ca...

CMS (Centers for Medicare & Medicaid Services) has recently released deductible, coinsurance, and premium rates for CY 2024. Here are the highlights: Part A Part A Deductible - $1,632.00 Part A Coinsurance - $408.00 per day for...

Does your office provide home health services to Medicare patients? Medicare has recently released its MLN Matters newsletter highlighting changes coming January 1, 2024. A link to the newsletter is below. Medicare Home Health PPS ...

Did you know that the amount in controversy to obtain an administrative law judge (ALJ) hearing and/or a judicial review in federal district court is changing effective January 1, 2024? Beginning January 1, 2024, the thresholds will be: ...

United Healthcare announced today that beginning on August 1, 2024, claims must include both an NPI and taxonomy code to be processed.   Here is the announcement from UHC: https://www.uhcprovider.com/en/resource-library/news/2024/ny-medicaid-npi...

Are you curious about the 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center?   See the article below from CMS for details.   https://www.cms.gov/newsroom/fact-sheets/cy-2025-medicare-hospital-outpatient-p...

CPT 2025 The 2025 CPT code set has been released by the American Medical Association and contains 420 updates.   These updates will be made to the DrChrono system for inclusion in your fee schedule and patient claims. ...