MLN Matters® Number: MM6533
Related Change Request (CR) #: 6533
Related CR Release Date: October 27, 2009
Effective Date: April 1, 2010
Related CR Transmittal #: R1836CP
Implementation Date: April 5, 2010
Provider Types Affected
This article is for physicians and non-physician practitioners who bill Medicare carriers and Medicare Administrative Contractors (A/B MAC) for providing psychiatric care to geriatric Medicare beneficiaries.
What You Need to Know
Effective April 1, 2010, the Centers for Medicare & Medicaid Services (CMS) will establish a new physician specialty code (code 27) for Geriatric Psychiatry. In addition, the codes 32, 74, and 75 are being removed from the physician specialty section of the Medicare Claims Processing Manual, because they are non-physician specialty codes. You should ensure that your billing staffs are aware of this new specialty code.
Background
When enrolling in Medicare, physicians self-designate their Medicare physician specialty on the Medicare enrollment application (CMS-855I) or Internet-based Provider Enrollment, Chain and Ownership System; and non-physician practitioners are assigned a Medicare specialty code. This specialty code becomes associated with the claims that the physician or non-physician practitioner submits, and describes the specific/unique types of medicine that physicians and non-physician practitioners (and certain other suppliers) practice. Moreover, CMS uses these specialty codes for programmatic and claims processing purposes.
CR 6533, from which this article is taken, announces that effective April 1, 2010, CMS will establish a new physician specialty code for Geriatric Psychiatry. For care you provide on or after that effective date, your carrier or A/B MAC will recognize and use specialty code 27 as a valid primary and/or secondary specialty code for Geriatric Psychiatry services provided by both individuals and organizations.
If you have any questions, please contact the Palmetto GBA Railroad Provider Contact Center at our toll-free number, (866) 332-7025 (Ohio and West Virginia) or (888) 828-2092 (South Carolina Part B).
Disclaimer
This article was prepared as a service to the public and is not intended to grant rights or impose obligations. This article may contain references or links to statutes, regulations, or other policy materials. The information provided is only intended to be a general summary. It is not intended to take the place of either the written law or regulations. We encourage readers to review the specific statutes, regulations and other interpretive materials for a full and accurate statement of their contents.