Understanding Medicare & Medicaid for Dually Eligible Beneficiaries
Understanding Medicare & Medicaid for Dually Eligible Beneficiaries Dually eligible beneficiaries are individuals who qualify for both Medicare and Medicaid, making them eligible for a broad range of healthcare services. These beneficiaries typically have limited income and resources, qualifying them for additional support to cover healthcare costs that Medicare does not fully pay. Here’s a […]
Transitional Care Management Services
Understanding Transitional Care Management (TCM) Services: A Comprehensive Guide Transitional Care Management (TCM) services play a crucial role in ensuring that patients who are discharged from inpatient care facilities receive the appropriate follow-up care necessary to transition smoothly back into their community settings. These services are vital for preventing readmissions, improving patient outcomes, and managing […]
Skilled Nursing Facility 3-Day Rule Billing
Understanding the Skilled Nursing Facility (SNF) 3-Day Rule for Medicare Billing Navigating Medicare’s billing requirements can be complex, especially when it comes to the Skilled Nursing Facility (SNF) 3-Day Rule. This rule is critical for ensuring that Medicare covers SNF services, and understanding it can help prevent denied claims and unexpected costs for patients. Here’s […]
Medicare Part D Vaccines
Navigating Medicare Part D Vaccines: A Comprehensive Guide for Providers Medicare Part D provides essential coverage for a wide range of vaccines, crucial for preventing illnesses in the Medicare population. Understanding the distinctions between what Medicare Part D and Part B cover, as well as how to properly bill for vaccines under Part D, is […]
Chronic Care Management Services
Chronic Care Management (CCM) services are essential in the ongoing care of patients with multiple chronic conditions, offering continuous support and coordination of care to improve health outcomes and reduce healthcare costs. The Centers for Medicare & Medicaid Services (CMS) recognizes CCM as a critical service and provides reimbursement for these non-face-to-face services under the […]
Understanding Medicare & Medicaid for Dually Eligible Beneficiaries
Dually eligible beneficiaries are individuals who qualify for both Medicare and Medicaid, making them eligible for a broad range of healthcare services. These beneficiaries typically have limited income and resources, qualifying them for additional support to cover healthcare costs that Medicare does not fully pay. Here’s a detailed guide to understanding the benefits, billing practices, […]
A Prescriber’s Guide to Medicare Prescription Drug (Part D) Opioid Policies
Comprehensive Guide to Chronic Care Management (CCM) Services Chronic Care Management (CCM) services are essential in the ongoing care of patients with multiple chronic conditions, offering continuous support and coordination of care to improve health outcomes and reduce healthcare costs. The Centers for Medicare & Medicaid Services (CMS) recognizes CCM as a critical service and […]
Replacement Wheelchair Equipment When Manufacturers Exit the Business
Hospice Payment Rates and Cap Updates
The Centers for Medicare & Medicaid Services (CMS) has issued Change Request (CR) 13707, effective October 1, 2024, which introduces critical updates to hospice payment rates, the hospice wage index, and the hospice cap amount for the fiscal year (FY) 2025. These changes are essential for hospice providers to understand and implement as they impact […]
Separate Payment for Disposable Negative Pressure Wound Therapy Devices
Starting January 1, 2024, the Centers for Medicare & Medicaid Services (CMS) will implement a significant change under Change Request (CR) 13244, which introduces separate payments for Disposable Negative Pressure Wound Therapy (dNPWT) devices under the Home Health Prospective Payment System (HH PPS). This update marks an important shift in how these devices are billed […]
