Medicare

  • All Things Medicare

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    Need help with Medicare payment issues or with Medicare coding? Do you need information about Medicare enrollment or about participation options? Or are you looking for information about the future of Medicare – what about the payment update, new provisions in the federal Affordable Care Act, new bonuses or new compliance requirements?

    What You Need to Know About Medicare  
  • Medicare Inquiries

    Do you have questions and need quick answers? Contact Novitas Solutions with questions.

    (855) 252-8782
    Mon.-Fri. (8 am-5 pm)

    Use these Novitas website links for quick information:

    IVR Flow Guide: Easily navigate Novitas' phone system.

    Medical Policy Search: Search by CPT and ICD-9 code or key word.

    CMS Fee Schedule

    You can also contact the TMA Knowledge Center at (800) 880-7955, or read the latest Medicare E-Tip from TMA.

  • Medicare Adds Telemedicine Codes

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    The newly adopted 2018 Medicare Physician Fee Schedule has added a few new codes to the list of telehealth services Medicare will cover.

    Find Out More  
  • Very Few U.S. Physicians to See Medicare Bonuses This Year

     

    Barely 20,000 clinicians nationwide will get bonuses of 6.6 percent to 19.9 percent per claim in their Medicare Physician Fee Schedule payments this year, according to results of the final 2018 Value-Based Payment Modifier (VM) program.

    Learn More
  • Replace Harmful Restrictions With Realistic Quality-Based Incentives

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    TMA believes the patient-physician relationship must be preserved regardless of patients’ health conditions, ethnicity, economic circumstances, demographics, or treatment compliance patterns. Unfortunately, many pay-for-performance strategies, commonly referred to as “value-based payment models,” that intend to contain health costs could undermine this relationship.

    Preserve Patient-Physician Relationship  
  • Current Medicare News

    Medicare-Eligible TRS Retirees Move to New Humana Health Plan
    If you were contracted with Humana MA, you will be paid your contracted rates. If you were not contracted with Humana and you elect to see patients covered under the new TRS-Care MA plan, Humana is required to pay you the Medicare-allowed amount.

    Can’t Say It Enough: Document, Document, Document
    When Medicare delves into claims errors, one stands out above the rest: insufficient documentation.

    Medicare Adds Telemedicine Codes
    The newly adopted 2018 Medicare Physician Fee Schedule has added a few new codes to the list of telehealth services Medicare will cover.

    Ten Services You Can Bill Medicare for Separately From a Surgical Procedure
    See which services fall outside “normal,” so you can bill Medicare for them separately from that surgical procedure.

    How to Identify Dual-Eligible Patients
    You must accept as payment in full the Medicare payment and Medicaid payment for services you provide to a patient enrolled in the Qualified Medicare Beneficiary (QMB) program.

    Ways to Avoid a Medicare Appeal
    Novitas Solutions reports receiving 1.7 million requests per year to correct minor errors or omissions of Medicare claim information. 

    Medicare Revalidation: It Begins Again 
    Medicare provider enrollment revalidation has entered phase two. The Centers for Medicare & Medicaid Services (CMS) has completed its initial round of revalidations under the Affordable Care Act (ACA) and will be resuming regular revalidation cycles — for physicians, that generally means revalidation every five years.

    Hospice Certification Form How-to
    Unclear about exactly what information a Medicare hospice certification or recertification form must contain? CMS offers guidance on essential elements the form must have.

  • Medicare Member Benefits

  • What could a TMA membership mean for you, your practice, and your patients?