PQRS Retired Claims-Based Measures
Measure # 79 End Stage Renal Disease (ESRD): Influenza Immunization in Patients with ESRD Measure # 94 Otitis Media with...
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Does coinsurance and Deductible applies for Home health services?
According to CMS Transmittals CR 3471 (20.4 – Exceptions to Annual Deductible and Coinsurance) neither the annual deductible nor the...
“Incident to” is a benefit category that allows Medicare to reimburse physicians for physician services as though the physician personally performed...
Aetna Code Edits and Claim Payment Policy
Surgical pathology As of October 17, 2010, 88346 (immunofluorescent study, each antibody; direct method) is allowed five times per date...
Electronic Prescribing (eRx) Incentive Program: Future Payment Adjustments
Under Section 1848(a)(5)(A) of the Social Security Act, for years 2012 through 2014, a Medicare Physician Fee Schedule (MPFS) payment...
Updating Beneficiary Information with the COBC
CMS Initiatives In compliance with Section 111 of the Medicare, Medicaid and State Children’s Health Insurance Program (SCHIP) Extension Act...
Medicaid of Georgia Reimbursement for Fluoride Varnish
Patients at risk for caries include those with: insufficient sources of dietary fluoride; high carbohydrate diets; caretakers who transmit decay-causing bacteria...
Medicaid reimbursement for Children’s Dental Services
Medicaid reimburses for children’s dental services rendered by licensed, Medicaid participating dentists. Medicaid reimbursable children’s dental services include: • Diagnostic...
Medicaid Reimbursement for Physician Services
Medicaid reimburses for services rendered by licensed, Medicaid-participating doctors of medicine or osteopathic medicine. The services can be rendered in the...
Medicaid Schedule for CHILD HEALTH CHECK-UP
Child Health Check-Up (formerly known as Early and Periodic Screening, Diagnosis and Treatment [EPSDT] services) consists of a comprehensive, preventive health screening that is...
Extension of Enforcement Discretion Period for Updated HIPAA Standards
On March 15, 2012, CMS’ Office of E-Health Standards and Services (OESS) announced that it will not initiate enforcement action...
Hospice is a program of care and support for people who are terminally ill. Here are some important facts about...