Medicare Medicaid
Information for psychiatrists who serve patients through Medicare, the federal health insurance program for the elderly and disabled; and Medicaid, the federally supported state-run health insurance programs for the poor.
Learn more about Medicare and Medicaid.
Information is available to Members through the Managed Care HelpLine by phone [800.343.4671] or email [hsf@psych.org]
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NEW [posted under Provider Alerts 8.2.10] CMS Education Series on the Medicare and Medicaid Electronc Health Record Incentive Programs
NEW [posted under Provider Alerts 6.30.10] Advice on Medicare Billing as of June 30, 2010
[posted under Medicare Fee Schedule 6.26.10] Medicare Physician Fee Schedule Update retroactive from June 1, 2010 Through November 30, 2010
CHANGE [posted 6.30.10] CMS to Review PECOS Enrollment Process
Notice from CMS:
Medicare is working with ordering and referring providers and supplies to streamline enrollment process to ensure that Medicare beneficiaries continue to receive the health care services and items they need.
CMS will, for the time being, not implement changes that would automatically reject claims based on orders, certifications, and referrals made by providers that have not yet had their applications approved by July 6, 2010.
Additionally, though CMS is taking a more deliberative approach to using the PECOS enrollment system, the agency will employ a contingency plan to meet the ACA requirement that written orders and certifications are only issued by eligible professionals effective July 1.
For more information read the CMS Press release issued today (6.30.10)
PECOS is the electronic system used to enroll physicians and eligible professionals into the Medicare program.
2010 Medicare News From HSF
Reminder: Consultation Code elimination effective 1.1.2010
Medicare eliminated the use of all consultation codes except those for telemedicine. Physicians are to bill for these services using the "most appropriate" remaining evaluation and management codes.
If you have questions about coding under this new policy, please contact Ellen Jaffe at 703-907-8591.
2010 Fee Schedule
2009 Medicare News from HSF
CMS Notices:
CMS Extends Deadline for 2010 Medicare Participation or Nonparticipation [posted 11/18.2009]
CMS announces payment, policy changes for physicians services to Medicare beneficiaries in 2010 [update posted 11.13.2009]
Scam Alert targeting physician offices [posted 6.18.2009]
Fact Sheet: CMS Form 1500 At a Glance [pdf document]
CMS Form 1500 Web-based Tutorial
:
Letter from CMS’s National Correct Coding Initiative (CCI) re inappropriate use of the Advance Beneficiary Notice (ABN) for claims denials based on CCI Medically Unlikely Edits (MUEs) rather than medical necessity. [posted 04/16/2009]
New Profider Authentication Requirements for Medicare Contractor provider Telephone and Written Inquiries [posted 04.15.09]
Posted 02.20.2009:
Internet-based Medicare Enrollment
Tips for Enrolling in Medicare
Posted 9.17.2008:
Reporting Responsibilities for Individual Physicians Enrolled in the Medicare Program
Reporting Responsibilities for Physician Group Practices Enrolled in the Medicare Program