New Billing Code: Know How and When to Use It Effective January 1, 2024, significant billing changes will be introduced for physicians and healthcare providers. Learn about the implementation of edits to prevent the payment of the complexity add-on code G2211 associated with specific outpatient evaluation and management visits, notably when reported with modifier 25.
CMS/NGS Monthly Meeting Time Change CMS/NGS is enhancing member access by adjusting the schedule for their monthly meetings. Starting December 12th, these meetings will now occur from 12-1 pm on every second Tuesday of the month. This change ensures our members can conveniently address their questions and concerns. Please share this information with your office
Federal Independent Dispute Resolution Process The Departments of Health and Human Services (HHS), Labor, and the Treasury (collectively, the Departments) are offering an extension of timelines related to: responding to a certified IDR entity’s request for additional information needed to determine a dispute’s eligibility for the Federal IDR process or to make a payment determination;
Discontinuation of Flovent in Dec 2023: Guidance from DOH Regarding the discontinuation of Flovent HFA and Diskus expected at the end of 2023, NYSDOH is proactively reviewing the status of medications within NYRx to ensure patients have a seamless transition to available products. The Corticosteroids-Inhaled drug class was reviewed at the September 2023 Drug Utilization
Aetna Telehealth Codes Update Starting 12/01/23 these Aetna Telehealth Codes are no longer covered.
Federal Independent Dispute Resolution Portal Re-Opened Effective October 6, to Initiate Certain Single and Bundled Disputes Effective October 6, 2023, the Departments have re-opened the Federal IDR portal for the initiation of certain new single and bundled disputes. On September 21, 2023, the Departments directed certified IDR entities to resume processing all in-progress single and
IDR Portal Now Open for New Disputes Starting October 6, 2023, the Federal IDR portal is available for initiating certain new single and bundled disputes. While batched and new air ambulance disputes are temporarily suspended, they are gradually reopening the portal. No Surprises Act | CMS
National Government Services: Medicare Part B Care Management Tuesdays According to the CDC, six in ten adults in the U.S. have a chronic disease, and four in ten adults have two or more. National Government Services is raising awareness of the benefits of care management services for Medicare beneficiaries with chronic conditions. NGS is devoting
New Proposed Fees for Federal Independent Dispute Resolution (IDR) Process Under No Surprises Act The Departments of Health and Human Services, Labor, and the Treasury (the Departments) released the Federal Independent Dispute Resolution (IDR) Process Administrative Fee and Certified IDR Entity Fee Ranges proposed rule. The rule proposes fee rates for the Federal IDR process
Transforming Insurance Challenges into $97,000 Triumph Meet Tamecca, a medical biller at Advanced Plastic Surgery of North Shore in Lake Success, NY, working alongside MSSNY member Dr. Mahira Tanovic, specializing in hand, plastics, and reconstructive surgeries. Dealing with insurance hurdles was a challenge as they faced non-payment or insufficient compensation for services rendered, with unexpected
