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 […]
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 […]
Refining Home Health Payment Reductions for Quality Data Submission

The Centers for Medicare & Medicaid Services (CMS) has issued an important update through Change Request (CR) 13241, which becomes effective on January 1, 2023. This update is designed to enhance the accuracy and efficiency of payment processes for Home Health Agencies (HHAs) that do not submit the required quality data. The update fully replaces […]