We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.

Published Date:07/01/2017

Printed Date: 9/22/2015

URL: http://palmgba.com/marlowe/redesign6/article.html

MLN Articles

Palmetto GBA maintains links recent released/revised CMS MLN Matters articles. All MLN Matters articles will continue to be available on the CMS MLN Matters website.

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Common Working File (CWF) Edits for Medicare Telehealth Services and Manual Update	03/25/2021
Updated Billing Requirements for Home Infusion Therapy (HIT) Services on or After January 1, 2021	03/25/2021
April Quarterly Update for 2021 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule	03/18/2021
Clinical Laboratory Fee Schedule - Medicare Travel Allowance Fees for Collection of Specimens	03/18/2021
Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment	03/18/2021
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2021 Update	03/18/2021
Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) & PC Print Update	03/18/2021
April 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files	02/24/2021
Billing for Services when Medicare is a Secondary Payer	02/24/2021
Healthcare Common Procedure Coding System (HCPCS) Codes Subject to and Excluded from Clinical Laboratory Improvement Amendments (CLIA) Edits	02/24/2021
International Classification of Diseases, 10th Revision (ICD10) and Other Coding Revisions to National Coverage Determination (NCDs) - April 2021	02/04/2021
Calendar Year (CY) 2021 Annual Update for Clinical Laboratory Fee Schedule and Services Subject to Reasonable Charge	01/27/2021
Certifying Patients for the Medicare Home Health Benefit	01/20/2021
January 2021 Update of the Ambulatory Surgical Center (ASC) Payment System	01/06/2021
Billing for Home Infusion Therapy Services On or After January 1, 2021	01/05/2021
2021 Annual Update to the Therapy Code List	01/04/2021
Addition of the QW Modifier to Healthcare Common Procedure Coding System (HCPCS) Codes 87811 and 87428	12/28/2020
Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 27.1, Effective April 1, 2021	12/28/2020
Updating Calendar Year (CY) 2021 Medicare Diabetes Prevention Program (MDPP) Payment Rates	12/28/2020
Telehealth Expansion Benefit Enhancement Under the Pennsylvania Rural Health Model (PARHM) - Implementation	12/23/2020
2021 Annual Update of Per-Beneficiary Threshold Amounts	12/08/2020
CY 2021 Update for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule	12/08/2020
Summary of Policies in the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services List	12/08/2020
FAQs on the 3-Day Payment Window for Services Provided to Outpatients Who Later Are Admitted as Inpatients	12/04/2020
Changes to the Laboratory National Coverage Determination (NCD) Edit Software for October 2020	12/01/2020
Claim Status Category and Claim Status Codes Update	11/24/2020
Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) CORE	11/24/2020
Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update	11/24/2020
Update to Medicare Deductible, Coinsurance and Premium Rates for Calendar Year (CY) 2021	11/24/2020
National Coverage Determination (NCD 90.3): Chimeric Antigen Receptor (CAR) T-cell Therapy	11/18/2020
Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)	11/10/2020
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - October 2020 Update	11/02/2020
Special Provisions for Radiology Additional Documentation Requests	11/02/2020
October Quarterly Update for 2020 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee Schedule	10/29/2020
Ambulance Inflation Factor (AIF) for Calendar Year (CY) 2021 and Productivity Adjustment	10/19/2020
Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)	10/19/2020
New Waived Tests	10/16/2020
January 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files	10/12/2020
New Physician Specialty Code for Micrographic Dermatologic Surgery (MDS) and Adult Congenital Heart Disease (ACHD) and a New Supplier Specialty Code for Home Infusion Therapy Services	09/28/2020
Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 27.0, Effective January 1, 2021	09/28/2020
October 2020 Update of the Ambulatory Surgical Center (ASC) Payment System	09/25/2020
Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment	09/25/2020
Update to the Medicare Claims Processing Manual	09/21/2020
2021 Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update	09/17/2020
National Coverage Determination (NCD 90.2): Next Generation Sequencing (NGS) for Medicare Beneficiaries with Germline (Inherited) Cancer	09/16/2020
Internet Only Manual Update to Pub. 100-04, Chapter 16, Section 60.1.2 and Pub. 100-04, Chapter 26, Section 10.4, Item 19	09/08/2020
National Coverage Determination (NCD 30.3.3): Acupuncture for Chronic Low Back Pain (cLBP)	09/02/2020
2021 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments	09/01/2020
Annual Clotting Factor Furnishing Fee Update 2021	09/01/2020
Claim Status Category and Claim Status Codes Updates	09/01/2020
Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) CORE	09/01/2020
Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)	08/28/2020
October 2020 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files	08/19/2020
Influenza Vaccine Payment Allowances - Annual Update for 2020-2021 Season	08/05/2020
International Classification of Diseases, 10th Revision (ICD10) and Other Coding Revisions to National Coverage Determination (NCDs)-January 2021 Update	08/05/2020
Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)	07/31/2020
New Waived Tests	07/29/2020
Addition of the QW Modifier to Healthcare Common Procedure Coding System (HCPCS) Code 87426	07/27/2020
Medicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)	07/27/2020
Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment	07/10/2020
July 2020 Update of the Ambulatory Surgical Center (ASC) Payment System	07/07/2020
Quarterly Healthcare Common Procedure Coding System (HCPCS) Drug/Biological Code Changes - July 2020 Update	07/07/2020
National Coverage Determination (NCD) 160.18 Vagus Nerve Stimulation (VNS)	06/25/2020
Quarterly Update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) Edits, Version 26.3, Effective October 1, 2020	06/24/2020
International Classification of Diseases, 10th Revision (ICD-10) and Other Coding Revisions to National Coverage Determination (NCDs) - July 2020 Update	06/23/2020
NCD (20.32) Transcatheter Aortic Valve Replacement (TAVR)	06/15/2020
Value-Based Insurance Design (VBID) Model - Implementation of the Hospice Benefit Component	06/11/2020
July Quarterly Update for 2020 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee Schedule	06/08/2020
Educational Resources to Assist Chiropractors with Medicare Billing	05/29/2020
Foot Care Coverage Guidelines	05/29/2020
Medicare Coverage for Chiropractic Services - Medical Record Documentation Requirements for Initial and Subsequent Visits	05/29/2020
Use of the AT modifier for Chiropractic Billing (New Information Along with Information in MM3449)	05/29/2020
Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) CORE	05/28/2020
Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update	05/27/2020
Summary of Policies in the Calendar Year (CY) 2020 Medicare Physician Fee Schedule (MPFS) Public Health Emergency (PHE) Interim Final Rules	05/27/2020
Therapy Codes Update	05/27/2020
Manual Update to Pub. 100-04, Chapter 38, to Remove Identification of Items or Services Related to the 2010 Oil Spill in the Gulf of Mexico Section	05/18/2020
National Coverage Determination (NCD) 20.19 Ambulatory Blood Pressure Monitoring (ABPM)	05/13/2020
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - July 2020 Update	05/13/2020
Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2020 Update	05/06/2020
Addition of the QW modifier to Healthcare Common Procedure Coding System (HCPCS) code U0002 and 87635	04/29/2020
Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Healthcare (CAQH) CORE	04/27/2020
New Medicare Beneficiary Identifier (MBI) Get It, Use It	03/20/2020
Incorrect Billing of HCPCS L8679 - Implantable Neurostimulator, Pulse Generator, Any Type	03/05/2020
NCD 20.4 Implantable Cardiac Defibrillators (ICDs)	03/04/2020
Proper Use of Modifier 59	03/04/2020
Section 1876 and 1833 Cost Plan Enrollee Access to Care through Original Medicare	03/04/2020
Standard Elements for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Order, and Master List of DMEPOS Items Potentially Subject to a Face-to-Face Encounter and Written Orders Prior to Delivery and, or Prior Authorization Requirements	02/28/2020
New Medicare Beneficiary Identifier (MBI) Get It, Use It	02/25/2020
Accepting Payment from Patients with a Medicare Set-Aside Arrangement	02/21/2020
Appropriate Use Criteria (AUC) for Advanced Diagnostic Imaging - Approval of Using the K3 Segment for Institutional Claims	02/21/2020
New Medicare Beneficiary Identifier (MBI) Get It, Use It	02/13/2020
Provider Compliance Tips for Polysomnography (Sleep Studies) - Revised	01/21/2020
Medicare Fee-for-Service (FFS) Response to the 2020 Commonwealth of Puerto Rico Earthquakes	01/14/2020
Medicare Part B Clinical Laboratory Fee Schedule: Revised Information for Laboratories on Collecting and Reporting Data for the Private Payor Rate-Based Payment System	01/09/2020
Medicare Part B Home Infusion Therapy Services With The Use of Durable Medical Equipment	12/16/2019
Overview of the Patient Driven Groupings Model	11/25/2019
Payments and Payment Adjustments under the Patient-Driven Groupings Model	11/25/2019
Hurricane Dorian and Medicare Disaster Related States of Georgia and South Carolina Claims	09/05/2019
Medicare Coverable Services for Integrative and Nonpharmacological Chronic Pain Management	08/21/2019
Pre-Diabetes Services: Referring Patients to the Medicare Diabetes Prevention Program	07/11/2019
Reduce Risk of Opioid Overdose Deaths by Avoiding and Reducing Co-Prescribing Benzodiazepines	07/11/2019
Guidance on Coding and Billing Date of Service on Professional Claims	02/04/2019
A Prescriber's Guide to the New Medicare Part D Opioid Overutilization Policies for 2019	11/02/2018
Reminder on Billing Requirements Implemented for non-OPPS Providers	09/05/2018
Review of Opioid Use during the Initial Preventive Physical Examination (IPPE) and Annual Wellness Visit (AWV)	08/30/2018
Current Medicare Coverage of Diabetes Supplies	08/17/2018
Prohibition Billing Dually Eligible Individuals Enrolled in the Qualified Medicare Beneficiary (QMB) Program	06/27/2018
Medicare Fee-for-Service (FFS) Response to the 2017 California Wildfires	04/03/2018
Medicare Fee-for-Service (FFS) Response to the 2017 Southern California Wildfires	04/03/2018
Proper Coding for Specimen Validity Testing Billed in Combination with Drug Testing	04/02/2018
Next Generation Accountable Care Organization - Implementation	01/25/2018
Medically Unlikely Edits (MUE) and Bilateral Surgical Procedures	01/18/2018