Home Health & Hospice Medicare Bulletin Index January ... · April 2020 Average Sales Price (ASP)...

Home Health & Hospice Medicare Bulletin Index

January - July 2020

© 2020 Copyright, CGS Administrators, LLC. 1

A

B

C

D

E

F

G H

I

J

K L

M

N

O

P

Q

R

S

T

U

V

W

X Y Z

A Advisory Group

2020 Home Health & Hospice Provider Outreach and Education (POE) Advisory Group Membership Drive .................................... February 2020, p. 10

Appeals

Provider Enrollment Appeals Procedure ....................................................... April 2020, p. 33

Average Sales Price (ASP)

April 2020 Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files ................. May 2020, p. 12

July 2020 Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files ................. May 2020, p. 15

B Top Billing

2020 Annual Update of Per-Beneficiary Threshold Amounts ..................... January 2020, p. 5 2020 Annual Update to the Therapy Code List ........................................ January 2020, p. 60 2020 Annual Update to the Therapy Code List (Revised) ............................... April 2020, p. 3 Accepting Payment from Patients with a

Medicare Set-Aside Arrangement (Revised) ....................................... April 2020, p. 44 Add Dates of Service (DOS) for Pneumococcal Pneumonia

Vaccination (PPV) Health Care Procedure Code System (HCPCS) Codes (90670, 90732), and Remove Next Eligible Dates for PPV HCPCS ............................................ February 2020, p. 13

Add Dates of Service (DOS) for Pneumococcal Pneumonia Vaccination (PPV) Health Care Procedure Code System (HCPCS) Codes (90670, 90732), and Remove Next Eligible Dates for PPV HCPCS (Revised) ................................ March 2020, p. 20


January - July 2020


Billing…continued

Add Dates of Service (DOS) for Pneumococcal Pneumonia Vaccination (PPV) Health Care Procedure Code System (HCPCS) Codes (90670, 90732), and Remove Next Eligible Dates for PPV HCPCS (Revised) ...................................... May 2020, p. 6

CY 2020 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule ................................................................................ February 2020, p. 20

CY 2020 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule (Revised) ................................................................... March 2020, p. 24

Ensure Required Patient Assessment Information for Home Health Claims ............................................................................ April 2020, p. 26

Home Health (HH) Patient-Driven Groupings Model (PDGM) – Revised and Additional Manual Instructions ..................................... January 2020, p. 3

Home Health Patient-Driven Groupings Model (PDGM) – Split Implementation (Revised) ....................................................... February 2020, p. 3

Home Health Patient-Driven Groupings Model (PDGM) Split Implementation (Revised) ........................................................... March 2020, p. 5

How Can You Reduce Errors for Reason Code (RC) 38107? ..................... March 2020, p. 4 How to Reduce Errors for Hospice Sequential Billing:

Reason Code 37402 ......................................................................... March 2020, p. 10 Manual Update to Publication (Pub.) 100-04, Chapter 20,

to Revise the Section 10 – Where to Bill Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Parenteral and Enteral Nutrition (PEN) Items and Services ............................................. February 2020, p. 14

New Codes for Therapist Assistants Providing Maintenance Programs in the Home Health Setting .............................. July 2020, p. 3

New Medicare Beneficiary Identifier (MBI) Get It, Use It (Reissued) .............................................................................. March 2020, p. 45

New Medicare Beneficiary Identifier (MBI) Get It, Use It (Revised) ................................................................................... April 2020, p. 46

New Medicare Beneficiary Identifier (MBI) Get It, Use It (Revised) .................................................................................... May 2020, p. 17


January - July 2020


Billing…continued

Quarterly Influenza Virus Vaccine Code Update – July 2020 ....................... April 2020, p. 38 Reason Code 37253: What to Look For ........................................................... May 2020, p. 3 Summary of Policies in the Calendar Year (CY) 2020

Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List ........................................................ February 2020, p. 16

Supplier Education on Use of Upgrades for Multi-Function Ventilators .................................................................... June 2020, p. 28

Therapy Codes Update (Revised) .................................................................... July 2020, p. 5 Top Home Health and Hospice Medical Review Denial Resources .......... March 2020, p. 49

C Top Claim Adjustment Reason Codes (CARC)

Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update ....................................... January 2020, p. 57

Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update ............................................ April 2020, p. 39

Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update ............................................. July 2020, p. 15

Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update (Revised) .............................. June 2020, p. 7

Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update (Revised) ............................ June 2020, p. 11


January - July 2020


Claim Status Category Codes

Claim Status Category and Claim Status Codes Update ......................... January 2020, p. 56 Claim Status Category Codes and Claim Status Codes Update ................... July 2020, p. 14 Claim Status Category and Claim Status Codes Update (Revised) ............... June 2020, p. 6

Claim Status Codes

Claim Status Category and Claim Status Codes Update ......................... January 2020, p. 56 Claim Status Category Codes and Claim Status Codes Update ................... July 2020, p. 14 Claim Status Category and Claim Status Codes Update (Revised) ............... June 2020, p. 6

Coronavirus (COVID-19)

Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) (Revised)........................ May 2020, p. 25

Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) (Revised)....................... June 2020, p. 24

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2020 Update (Revised) ......... June 2020, p. 12

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – July 2020 Update ............................ July 2020, p. 19

Summary of Policies in the Calendar Year (CY) 2020 Medicare Physician Fee Schedule (MPFS) Public Health Emergency (PHE) Interim Final Rule ................................................... July 2020, p. 23

Update to the Home Health Grouper for New Diagnosis Code for Vaping Related Disorder and COVID-19 (Revised) ............... June 2020, p. 3

Credit Balance Report (CBR)

Quarterly Reminder .................................................................................. January 2020, p. 27 April 2020, p. 31 July 2020, p. 8


January - July 2020


D Top Diagnosis

Update to the Home Health Grouper for New Diagnosis Code for Vaping Related Disorder ....................................................... April 2020, p. 20


Drugs

April 2020 Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files ................. May 2020, p. 12

July 2020 Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files ................. May 2020, p. 15

Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)

April Quarterly Update for 2020 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule ........................................................................................ May 2020, p. 13

CY 2020 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule ................................................................................ February 2020, p. 20

CY 2020 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule (Revised) ................................................................... March 2020, p. 24

Manual Update to Publication (Pub.) 100-04, Chapter 20, to Revise the Section 10 – Where to Bill Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Parenteral and Enteral Nutrition (PEN) Items and Services ............................................. February 2020, p. 14

Medicare Part B Home Infusion Therapy Services With The Use of Durable Medical Equipment (Revised) ...................... February 2020, p. 28


January - July 2020


Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS)…continued

Standard Elements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Order, and Master List of DMEPOS Items Potentially Subject to a Face-to-Face Encounter and Written Orders Prior to Delivery and, or Prior Authorization Requirements ......................................................... May 2020, p. 21

E Top

Electronic Funds Transfer

Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE .............................................................................................. January 2020, p. 59

Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE .................................................................................................... July 2020, p. 16

Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE (Revised) .................................................................................... June 2020, p. 9


January - July 2020


Electronic Medical Documentation Requests (eMDR)

Implementation to Exchange the List of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System (Revised) ..................................... January 2020, p. 29

Implementation to Exchange the List of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System (Revised) ....................................... March 2020, p. 13

F Top

Fee Schedule

April Quarterly Update for 2020 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule ........................................................................................ May 2020, p. 13

G Top

H Top Health Maintenance Organization (HMO)

Section 1876 and 1833 Cost Plan Enrollee Access to Care through Original Medicare ....................................................... May 2020, p. 24

Healthcare Common Procedure Coding System (HCPCS)

Add Dates of Service (DOS) for Pneumococcal Pneumonia Vaccination (PPV) Health Care Procedure Code System (HCPCS) Codes (90670, 90732), and Remove Next Eligible Dates for PPV HCPCS ............................................ February 2020, p. 13


January - July 2020


Healthcare Common Procedure Coding System (HCPCS)…continued



April 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) (Revised) ........................... January 2020, p. 36

April 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) ................................................ June 2020, p. 18

January 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) ............................................. March 2020, p. 32

January 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) (Revised) .................................. April 2020, p. 5

October 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) (Revised) ........................... January 2020, p. 47

Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – October 2019 Update (Revised) ..................................................... January 2020, p. 42

Home Health

2020 Annual Update of Per-Beneficiary Threshold Amounts ..................... January 2020, p. 5 Ensure Required Patient Assessment Information for

Home Health Claims ............................................................................ April 2020, p. 26 Home Health Agencies (HHAs) Urged to Establish Access to the

Internet Quality Improvement and Evaluation System (iQIES) By December 23, 2019 ................................................................... January 2020, p. 11




January - July 2020


Home Health…continued


Home Health Physician Certification Date.................................................... March 2020, p. 3 Home Health Plans of Care: NPs, CNSs, and Pas Allowed to Certify ............. July 2020, p. 3 Home Health Prospective Payment System

(HH PPS) Rate Update for Calendar Year (CY) 2020 ...................... January 2020, p. 6 Home Health Prospective Payment System (HH PPS)

Rate Update for Calendar Year (CY) 2020 (Revised) .................... February 2020, p. 5 How Can You Reduce Errors for Reason Code (RC) 38107? ..................... March 2020, p. 4 Manual Updates Related to Calendar Year (CY) 2020 Home

Health Payment Policy Changes, Maintenance Therapy, and Remote Patient Monitoring ........................................... March 2020, p. 8


New Physician Specialty Code for Micrographic Dermatologic Surgery (MDS) and Adult Congenital Heart Disease (ACHD) and a New Supplier Specialty Code for Home Infusion Therapy Services.......................................................... July 2020, p. 18

Overview of the Patient Driven Groupings Model .................................... January 2020, p. 14 Payments and Payment Adjustments under the

Patient-Driven Groupings Model .................................................... January 2020, p. 20 Reason Code 37253: What to Look For ........................................................... May 2020, p. 3 Supplier Education on Use of Upgrades for

Multi-Function Ventilators .................................................................... June 2020, p. 28 Targeted Probe and Educate Progress Update ............................................ April 2020, p. 50 The Role of Therapy under the Home Health

Patient-Driven Groupings Model (PDGM) ........................................... April 2020, p. 23 Therapy Codes Update (Revised) .................................................................... July 2020, p. 5 Top Home Health and Hospice Medical Review Denial Resources .......... March 2020, p. 49 Update to the Home Health Grouper for New Diagnosis

Code for Vaping Related Disorder ....................................................... April 2020, p. 20


January - July 2020


Home Health…continued


What New Home Health Agencies (HHAs) Need to Know About Being Placed in a Provisional Period of Enhanced Oversight (Revised) ............................................................................. April 2020, p. 21

Home Health Patient-Driven Groupings Model (PDGM)





Manual Updates Related to Calendar Year (CY) 2020 Home Health Payment Policy Changes, Maintenance Therapy, and Remote Patient Monitoring ........................................... March 2020, p. 8

Overview of the Patient Driven Groupings Model .................................... January 2020, p. 14 Payments and Payment Adjustments under the

Patient-Driven Groupings Model .................................................... January 2020, p. 20 The Role of Therapy under the Home Health

Patient-Driven Groupings Model (PDGM) ........................................... April 2020, p. 23

Hospice

Hospice Certification of Terminal Illness Resources ..................................... April 2020, p. 28 Hospice Interdisciplinary Review/Plan of Care Update Reminder ............. March 2020, p. 10 Hospice Self-Determined Aggregate Cap Reminder .............................. February 2020, p. 10 How to Reduce Errors for Hospice Sequential Billing:

Reason Code 37402 ......................................................................... March 2020, p. 10 New Hospice Clinical Resources ...................................................................... July 2020, p. 7 Targeted Probe and Educate Progress Update ............................................ April 2020, p. 50 Top Home Health and Hospice Medical Review Denial Resources .......... March 2020, p. 49


January - July 2020


I Top Interest

Update to the Interest Paid on Clean Non-PIP Claims Not Paid Timely............................................................................. February 2020, p. 33

Integrated Outpatient Code Editor (I/OCE)

April 2020 Integrated Outpatient Code Editor (I/OCE) Specifications Version 21.1 .................................................................. May 2020, p. 10

April 2020 Integrated Outpatient Code Editor (I/OCE) Specifications Version 21.1 (revised) .................................................. June 2020, p. 16

January 2020 Integrated Outpatient Code Editor (I/OCE) Specifications Version 21.0 .............................................................. March 2020, p. 21

January 2020 Integrated Outpatient Code Editor (I/OCE) Specifications Version 21.0 (Revised) ................................................. April 2020, p. 35

Internet Quality Improvement and Evaluation System (iQIES)

Home Health Agencies (HHAs) Urged to Establish Access to the Internet Quality Improvement and Evaluation System (iQIES) By December 23, 2019 ................................................................... January 2020, p. 11

Reason Code 37253: What to Look For ........................................................... May 2020, p. 3

J Top

K Top

L Top


January - July 2020


M Top Medicare Beneficiary Identifier (MBI)

New Medicare Beneficiary Identifier (MBI) Get It, Use It (Reissued) .............................................................................. March 2020, p. 45

New Medicare Beneficiary Identifier (MBI) Get It, Use It (Revised) ................................................................................... April 2020, p. 46

New Medicare Beneficiary Identifier (MBI) Get It, Use It (Revised) .................................................................................... May 2020, p. 17

Medicare Learning Network® (MLN)

MM11003 (Revised): Implementation to Exchange the List of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System ........................................ January 2020, p. 29

MM11003 (Revised): Implementation to Exchange the List of Electronic Medical Documentation Requests (eMDR) for Registered Providers via the Electronic Submission of Medical Documentation (esMD) System .......................................... March 2020, p. 13

MM11081 (Revised): Home Health Patient-Driven Groupings Model (PDGM) – Split Implementation ........................................... February 2020, p. 3

MM11081 (Revised): Home Health Patient-Driven Groupings Model (PDGM) – Split Implementation ............................................... March 2020, p. 5

MM11210: Provider Enrollment Appeals Procedure ..................................... April 2020, p. 33 MM11216 (Revised): April 2019 Update of the Hospital Outpatient

Prospective Payment System (OPPS) ........................................... January 2020, p. 36 MM11335 (Revised): Add Dates of Service (DOS) for

Pneumococcal Pneumonia Vaccination (PPV) Health Care Procedure Code System (HCPCS) Codes (90670, 90732), and Remove Next Eligible Dates for PPV HCPCS ................................................................. February 2020, p. 13


January - July 2020


Medicare Learning Network® (MLN)…continued

MM11335 (Revised): Add Dates of Service (DOS) for Pneumococcal Pneumonia Vaccination (PPV) Health Care Procedure Code System (HCPCS) Codes (90670, 90732), and Remove Next Eligible Dates for PPV HCPCS ..................................................................... March 2020, p. 20

MM11335 (Revised): Add Dates of Service (DOS) for Pneumococcal Pneumonia Vaccination (PPV) Health Care Procedure Code System (HCPCS) Codes (90670, 90732), and Remove Next Eligible Dates for PPV HCPCS ........................................................................... May 2020, p. 6

MM11422 (Revised): Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes – October 2019 Update ..................................................................... January 2020, p. 42

MM11451 (Revised): October 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) ........................................... January 2020, p. 47

MM11453: Medicare Physician Fee Schedule Database (MPFSDB) Update to Status Indicators .......................................... January 2020, p. 55

MM11467: Claim Status Category and Claim Status Codes Update ...................................................................... January 2020, p. 56

MM11467 (Revised): Claim Status Category and Claim Status Codes Update ............................................................................. June 2020, p. 6

MM11489: Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update ....................................... January 2020, p. 57

MM11489 (Revised): Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update .............................................. June 2020, p. 7


January - July 2020



MM11490: Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE .............................................................................................. January 2020, p. 59

MM11490 (Revised): Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE ..................................................................................................... June 2020, p. 9

MM11501: 2020 Annual Update to the Therapy Code List ...................... January 2020, p. 60 MM11501 (Revised): 2020 Annual Update to the Therapy Code List ............. April 2020, p. 3 MM11527: Home Health (HH) Patient-Driven Groupings

Model (PDGM) – Revised and Additional Manual Instructions ........................................................................................ January 2020, p. 3

MM11532: 2020 Annual Update of Per-Beneficiary Threshold Amounts ........................................................................... January 2020, p. 5

MM11536: Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2020 ...................... January 2020, p. 6

MM11536 (Revised): Home Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2020 .................... February 2020, p. 5

MM11554: Manual Update to Publication (Pub.) 100-04, Chapter 20, to Revise the Section 10 – Where to Bill Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) and Parenteral and Enteral Nutrition (PEN) Items and Services ............................................. February 2020, p. 14


January - July 2020



MM11560: Summary of Policies in the Calendar Year (CY) 2020 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List ........................................................ February 2020, p. 16

MM11564: January 2020 Integrated Outpatient Code Editor (I/OCE) Specifications Version 21.0 .............................................................. March 2020, p. 21

MM11564 (Revised): January 2020 Integrated Outpatient Code Editor (I/OCE) Specifications Version 21.0 .......................................... April 2020, p. 35

MM11570: CY 2020 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule ................................................................................ February 2020, p. 20

MM11570 (Revised): CY 2020 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule .................................................................................... March 2020, p. 24

MM11577: Manual Updates Related to Calendar Year (CY) 2020 Home Health Payment Policy Changes, Maintenance Therapy, and Remote Patient Monitoring ........................................... March 2020, p. 8

MM11603: Quarterly Influenza Virus Vaccine Code Update – July 2020 ..... April 2020, p. 38 MM11605: January 2020 Update of the Hospital Outpatient

Prospective Payment System (OPPS) ............................................. March 2020, p. 32 MM11605 (Revised): January 2020 Update of the Hospital Outpatient

Prospective Payment System (OPPS) .................................................. April 2020, p. 5 MM11638: Remittance Advice Remark Code (RARC),

Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update .................................. April 2020, p. 39

MM11638 (Revised): Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update .................................. June 2020, p. 11

MM11656: Update to the Home Health Grouper for New Diagnosis Code for Vaping Related Disorder ....................................................... April 2020, p. 20

MM11656 (Revised): Update to the Home Health Grouper for New Diagnosis Code for Vaping Related Disorder and COVID-19 ................................ June 2020, p. 3


January - July 2020



MM11661: Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2020 Update .......................... April 2020, p. 40

MM11661 (Revised): Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2020 Update ...................... May 2020, p. 7

MM11661: Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2020 Update .......................... June 2020, p. 12

MM11661 (Revised): Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2020 Update ........................... July 2020, p. 10

MM11669: Claim Status Category Codes and Claim Status Codes Update ....................................................................................... July 2020, p. 14

MM11680: April 2020 Integrated Outpatient Code Editor (I/OCE) Specifications Version 21.1 .................................................................. May 2020, p. 10

MM11680 (Revised): April 2020 Integrated Outpatient Code Editor (I/OCE) Specifications Version 21.1 .......................................... June 2020, p. 16

MM11691: April 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) ................................................ June 2020, p. 18

MM11701: April 2020 Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files ........ May 2020, p. 12

MM11702: April Quarterly Update for 2020 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule ........................................................................................ May 2020, p. 13

MM11708: Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update ............................................. July 2020, p. 15

MM11709: Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE .................................................................................................... July 2020, p. 16

MM11721: New Codes for Therapist Assistants Providing Maintenance Programs in the Home Health Setting .............................. July 2020, p. 3


January - July 2020



MM11745: July 2020 Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files .......................................................................... May 2020, p. 15

MM11750: New Physician Specialty Code for Micrographic Dermatologic Surgery (MDS) and Adult Congenital Heart Disease (ACHD) and a New Supplier Specialty Code for Home Infusion Therapy Services.......................................................... July 2020, p. 18

MM11778: Manual Update to Pub. 100-04, Chapter 38, to Remove Identification of Items or Services Related to the 2010 Oil Spill in the Gulf of Mexico Section ................................................... July 2002, p. 18

MM11788: Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – July 2020 Update ............................ July 2020, p. 19

MM11791 (Revised): Therapy Codes Update .................................................. July 2020, p. 5 MM11805: Summary of Policies in the Calendar Year (CY) 2020

Medicare Physician Fee Schedule (MPFS) Public Health Emergency (PHE) Interim Final Rule ................................................... July 2020, p. 23

SE17019 (Revised): Accepting Payment from Patients with a Medicare Set-Aside Arrangement........................................................ April 2020, p. 44

SE18006 (Reissued): New Medicare Beneficiary Identifier (MBI) Get It, Use It ............................................................. March 2020, p. 45

SE18006 (Revised): New Medicare Beneficiary Identifier (MBI) Get It, Use It ................................................................ April 2020, p. 46

SE18006 (Reissued): New Medicare Beneficiary Identifier (MBI) Get It, Use It ................................................................. May 2020, p. 17

SE19005 (Revised): What New Home Health Agencies (HHAs) Need to Know About Being Placed in a Provisional Period of Enhanced Oversight ............................................................. April 2020, p. 21

SE19025: Home Health Agencies (HHAs) Urged to Establish Access to the Internet Quality Improvement and Evaluation System (iQIES) By December 23, 2019 ....................... January 2020, p. 11

SE19027: Overview of the Patient Driven Groupings Model .................... January 2020, p. 14 SE19028: Payments and Payment Adjustments under the

Patient-Driven Groupings Model .................................................... January 2020, p. 20


January - July 2020



SE19029 (Revised): Medicare Part B Home Infusion Therapy Services With The Use of Durable Medical Equipment ................ February 2020, p. 28

SE20005: The Role of Therapy under the Home Health Patient-Driven Groupings Model (PDGM) ........................................... April 2020, p. 23

SE20007: Standard Elements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Order, and Master List of DMEPOS Items Potentially Subject to a Face-to-Face Encounter and Written Orders Prior to Delivery and, or Prior Authorization Requirements .............................. May 2020, p. 21

SE20009: Section 1876 and 1833 Cost Plan Enrollee Access to Care through Original Medicare ....................................................... May 2020, p. 24

SE20010: Ensure Required Patient Assessment Information for Home Health Claims ............................................................................ April 2020, p. 26

SE20011 (Revised): Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) ........ May 2020, p. 25

SE20011 (Revised): Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) ....... June 2020, p. 24

SE20012: Supplier Education on Use of Upgrades for Multi-Function Ventilators .................................................................... June 2020, p. 28

Medicare Physician Fee Schedule (MPFS)

Summary of Policies in the Calendar Year (CY) 2020 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List ........................................................ February 2020, p. 16


January - July 2020


Medicare Physician Fee Schedule Database (MPFSDB)

Medicare Physician Fee Schedule Database (MPFSDB) Update to Status Indicators .......................................... January 2020, p. 55

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2020 Update .......................... April 2020, p. 40

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2020 Update (Revised) ............ May 2020, p. 7

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2020 Update (Revised) ......... June 2020, p. 12

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – April 2020 Update (Revised) .......... July 2020, p. 10

Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) – July 2020 Update ............................ July 2020, p. 19


Medicare Secondary Payer (MSP)

Accepting Payment from Patients with a Medicare Set-Aside Arrangement (Revised) ....................................... April 2020, p. 44

Medicare Set-Aside Arrangement

Accepting Payment from Patients with a Medicare Set-Aside Arrangement (Revised) ....................................... April 2020, p. 44

MLN Connects®

April 2020 – May 2020 Weekly Messages ...................................................... June 2020, p. 6 December 2019 – January 2020 Weekly Messages .............................. February 2020, p. 12 February 2020 – March 2020 Weekly Message ............................................ April 2020, p. 33 January 2020 – February 2020 Weekly Messages .................................... March 2020, p. 13 March 2020 – April 2020 Weekly Messages .................................................... May 2020, p. 5 May 2020 - Jun November 2019 – December 2019 Weekly Messages ............................ January 2020, p. 29


January - July 2020


N Top

O Top Outcome and Assessment Information Set (OASIS)


Reason Code 37253: What to Look For ........................................................... May 2020, p. 3

Outpatient Prospective Payment System (OPPS)

April 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) (Revised) ........................... January 2020, p. 36

April 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) ................................................ June 2020, p. 18

January 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) ............................................. March 2020, p. 32

January 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) (Revised) .................................. April 2020, p. 5

October 2019 Update of the Hospital Outpatient Prospective Payment System (OPPS) (Revised) ........................... January 2020, p. 47

P Top PC Print Software





January - July 2020


PC Print Software…continued



Pneumococcal Pneumonia Vaccination (PPV)

Add Dates of Service (DOS) for Pneumococcal Pneumonia Vaccination (PPV) Health Care Procedure Code System (HCPCS) Codes (90670, 90732), and Remove Next Eligible Dates for PPV HCPCS ............................................ February 2020, p. 13



Provider Enrollment

Provider Enrollment Appeals Procedure ....................................................... April 2020, p. 33

Provisional Period of Enhanced Oversight

What New Home Health Agencies (HHAs) Need to Know About Being Placed in a Provisional Period of Enhanced Oversight (Revised) ............................................................................. April 2020, p. 21


January - July 2020


Public Health Emergency (PHE)

Manual Update to Pub. 100-04, Chapter 38, to Remove Identification of Items or Services Related to the 2010 Oil Spill in the Gulf of Mexico Section ................................................... July 2002, p. 18


Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19) (Revised)....................... June 2020, p. 24


Q Top

Quarterly Provider Update

CMS Comprehensive Resource ............................................................... January 2020, p. 62 April 2020, p. 43 July 2020, p. 29

R Top Refund Checks

Reminder: Where to Send Refund Checks .................................................... May 2020, p. 16

Remittance Advice





January - July 2020


Remittance Advice…continued



Remittance Advice Remark Codes (RARC)

Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE .............................................................................................. January 2020, p. 59

Implement Operating Rules – Phase III Electronic

Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE .................................................................................................... July 2020, p. 16


January - July 2020


Remittance Advice Remark Codes (RARC)…continued

Implement Operating Rules – Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC), and Claim Adjustment Group Code (CAGC) Rule – Update from Council for Affordable Quality Healthcare (CAQH) CORE (Revised) .................................................................................... June 2020, p. 9






S Top

T Top Target Probe and Education (TPE)

Targeted Probe and Educate Progress Update ............................................ April 2020, p. 50


January - July 2020


Telehealth


Therapy

2020 Annual Update of Per-Beneficiary Threshold Amounts ..................... January 2020, p. 5 2020 Annual Update to the Therapy Code List ........................................ January 2020, p. 60 2020 Annual Update to the Therapy Code List (Revised) ............................... April 2020, p. 3 Manual Updates Related to Calendar Year (CY) 2020 Home

Health Payment Policy Changes, Maintenance Therapy, and Remote Patient Monitoring ........................................... March 2020, p. 8


The Role of Therapy under the Home Health Patient-Driven Groupings Model (PDGM) ........................................... April 2020, p. 23

Therapy Codes Update (Revised) .................................................................... July 2020, p. 5

U Top

V Top Vaccine

Quarterly Influenza Virus Vaccine Code Update – July 2020 ....................... April 2020, p. 38


January - July 2020


W Top Website

CGS Website Updates .............................................................................. January 2020, p. 27 February 2020, p. 11 March 2020, p. 12 April 2020, p. 30 May 2020, p. 4 June 2020, p. 4 July 2020, p. 7 New Hospice Clinical Resources ...................................................................... July 2020, p. 7

X Top

Y Top

Z Top

Home Health & Hospice Medicare Bulletin Index January ... · April 2020 Average Sales Price (ASP)...

Documents

Transcript of Home Health & Hospice Medicare Bulletin Index January ... · April 2020 Average Sales Price (ASP)...