There are several changes coming to Medicare benefits for 2021: Every year, a cost-of-living adjustment (COLA) is announced. In 2020, benefits increased by 1.6% and for 2021, benefits will increase by 1.3%. This will result in an average increase of about $20 per month. The Medicare cost increases for 2021 are as follows The standard […]
It’s Flu Season – What you need to know!
It’s Flu Season! The 2020 – 2021 flu season is here and with COVID-19 still circulating, it’s more important than ever to get a flu vaccine. Since both the flu and COVID-19 have some similar symptoms, the Center for Disease Control and Prevention recommends that all persons 6 months and older receive a flu vaccine. […]
November Bulletin – UnitedHealthcare’s COVID-19 Response – Update
UnitedHealthcare’s COVID-19 Response – Update Telehealth Throughout the public health emergency (currently set to end on January 20, 2021), UHC is extending the cost share waiver for COVID-19 in-network telehealth services. UHC will also waive cost share for COVID-19 treatment until December 31, 2020. For out-of-network services, the cost share for COVID-19 testing […]
THE AMERICAN MEDICAL ASSOCIATION RELEASES NEW CPT CODES SURROUNDING THE COVID-19 PANDEMIC
Over the last several months, the COVID-19 Pandemic has changed the course of the medical industry and The American Medical Association has approved new CPT codes for use during the COVID-19 public health emergency. Two new Category I CPT Codes were announced on September 8, 2020 for immediate use to meet the rapidly changing needs […]
CMS Announces Additional HCPCS Codes Related to Lab Testing for Covid-19
On February 13, 2019 The Centers for Medicare & Medicaid Services issued an alert to ensure that patients have access to laboratory testing in response to the threat of Novel Coronavirus (COVID-19). CMS issued a new HCPCS code (U0001). This new code is for labs utilizing the Centers for Disease Control and Prevention (CDC) 2019 […]
Top Challenges Facing Labs Today: 4 Key Takeaways From Lab Institute 2017
Representatives of Physicians Group Management (PGM Billing) recently returned from attending and exhibiting at Lab Institute 2017. This meeting, hosted by G2 Intelligence, brings together professionals from throughout the lab industry for three days of education and networking. In this ever-changing, ever-evolving healthcare environment, many sessions focused on the top challenges facing laboratories. Here are […]
Medicare Provides Guidance on Laboratory Services Consolidated Billing
When laboratory services are billed by providers other than the end-stage renal disease (ESRD) facility and the laboratory service furnished is designated as a service that is included in the ESRD Prospective Payment System (PPS), Medicare will reject or deny the claim. This is according to recent issue of Medicare Quarterly Provider Compliance Newsletter, a […]
Medicare Provides Guidance on Facet Joint Injection Billing
Medicare has found that insufficient documentation is a common cause for improper payments for facet joint injection procedures. This is according to a recent issue of Medicare Quarterly Provider Compliance Newsletter, a newsletter from CMS developed to help providers to avoid common billing errors and other erroneous activities when dealing with the Medicare Program. The […]
CMS Increases Definitive Drug Testing Reimbursement
The Centers for Medicare & Medicaid Services (CMS) will increase reimbursement for toxicology drug confirmation codes in 2017. Background For 2016, CMS implemented four new HCPCS G codes for definitive drug testing: G0480 G0481 G0482 G0483 CMS priced these codes using a crosswalking fo rmula. The first two tests performed were paid at the full […]
Gastroenterology Billing Compliance: Enteral Infusion Pumps
The Centers for Medicare & Medicaid Services (CMS) has released a video that contains guidance to help providers bill correctly for enteral infusion pumps. Medicare Part B covers enteral nutrition supplies and equipment (feeding pump) under the prosthetic device benefit. The two-minute video discusses Medicare coverage criteria for enteral infusion pumps and the four pieces […]