Tag: Medicare Coverage

DSMT and MNT

 DSMT and MNT: A Comprehensive Guide for Healthcare Providers

As diabetes prevalence increases, the importance of diabetes self-management training (DSMT) and medical nutrition therapy (MNT) becomes undeniable. To empower patients, optimize health outcomes, and ensure sustainable access, healthcare systems must integrate DSMT and MNT into diabetes care protocols. This article highlights the critical role of registered dietitians (RDs) and nutrition professionals in providing these […]
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Medicare appeals process

New CMS Rule: Medicare Appeals Process for Reclassified Patients

On October 11th, the Centers for Medicare & Medicaid Services (CMS) issued a final rule establishing a new Medicare appeals process for Medicare beneficiaries who are initially admitted to a hospital as inpatients but later reclassified as outpatients receiving observation services. This rule is a result of the class-action lawsuit that sought to establish appeal […]
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Preventive-Visits-VS-Office-Visits

Differences: Preventive vs. Office Visits in Medical Coding & Billing

Preventive Services Vs Office Visits: It is important to note that Medicare does not cover preventive services in the same manner as commercial payers. Therefore, it is important to know the patient’s policy and insurance coverage. Table A shows a breakdown of the coverage parameters. Understanding the distinction between Preventive Services Vs Office Visits is […]
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Medicare-Advantage-Bill-Response-To-Complaints

The Medicare Advantage Bill Was Crafted In Response To Complaints

The bill was crafted partly in response to rising complaints among seniors over aggressive marketing practices for Medicare Advantage plans. U.S. Sens. Maggie Hassan, D-N.H., and Dr. Roger Marshall, R-Kansas, have introduced the bipartisan Medicare & You Handbook Improvement Act, which is meant to ensure that when seniors assess their Medicare coverage options, they have the necessary […]
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cms-aims-eliminate-delays-new-medicare-coverage-and-expand-special-enrollment-periods

CMS aims to eliminate delays in new Medicare coverage, expand special enrollment periods

The Biden administration wants to close the gap before new Medicare beneficiaries can get coverage and expand use of special enrollment periods. The Centers for Medicare & Medicaid Services (CMS) issued a proposed rule Friday that updated Medicare enrollment and eligibility rules. One of the key proposals is to provide Medicare coverage a month immediately […]
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telehealth-update-new-bill

Telehealth Update: New Bill Could Provide Much Needed Certainty to Providers and Patients

On Monday, February 7, 2022, U.S. Senators Catherine Cortez Masto, D-Nevada, and Todd Young, R-Indiana, introduced the Telehealth Extension and Evaluation Act, which if passed, would extend several of the telehealth waivers for two years after the end of the federal public health emergency (PHE).  See our previous coverage of telehealth during the COVID-19 pandemic. […]
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covid-19-monoclonal-antibody-billing-update

COVID-19 Monoclonal Antibody Billing Update

  Ever since a public health emergency (PHE) for COVID-19 was declared on Jan. 27, 2020, there has been several new HCPCS Level II codes created for monoclonal antibody (mAb) products and administration. As confusing as all these new codes and billing requirements have been, nothing has caused as much trouble as the latest change […]
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