The third major COVID-19 relief measure includes promising funding for a variety of important health measures in Texas. But there’s also the prospect of a Medicare physician payment cut.
Federal lawmakers are moving forward on extending the suspension of the Medicare sequestration, the federal government’s 2% across-the-board payment cut, through the end of the year.
Many health insurers in Texas are waiving patient costs associated with COVID-19. Last week in a news release, Gov. Greg Abbott and the Texas Department of Insurance asked insurers and HMOs to cover testing consistent with Centers for Disease Control and Prevention guidance, and telemedicine visits.
Confused by Each Payer’s COVID-19 Policies? TMA is Here to Help
Medicare to Pay for Counseling Patients to Self-Isolate During COVID-19 Testing
Medicare Coverage and Payment Related to COVID-19 (CMS, March 5, 2020)
FAQs to Assist Medicare Providers With Billing and Coding for COVID-19 Testing (CMS, March 6, 2020)
Medicare: Coverage and Payment Related to COVID-19 (CMS, March 23, 2020)
CMS Offers More Flexibility, Financial Stability for COVID-19 Care
Flexibilities to Fight COVID-19 (CMS, March 30, 2020)
Federal Register: Medicare and Medicaid Programs: Policy and Regulatory Revisions (HHS, March 24, 2020)
COVID-19 Medicare Enrollment Relief FAQs
Medicare Telemedicine Fact Sheet
CMS Adult Elective Surgery and Procedures Recommendations
Go to the TMA COVID-19 Resource Center
As you’re no doubt aware, telemedicine has made it possible for many physicians to continue seeing patients while reducing the risk of spread during the COVID-19 pandemic.
Temporary changes to state and federal rules, particularly regarding payment for services, have helped push up the new demand for and use of telemedicine.
In the wake of COVID-19, TMA is getting calls about which payers are covering telemedicine. TMA developed this quick reference guide to help you navigate telemedicine reimbursement. This table now reflects Medicare’s waiver of the geographic and place of service restrictions for Medicare (which means patients can now be at home).
Additionally, the Governor directed TDI to issue an emergency rule related to the payment of telemedicine to allow state-regulated plans (about 20% of the commercial market in Texas) to allow telephone and telemedicine visits to be paid at the same rate as in-office visits. If you are not sure which patients are regulated by TDI, check this guide. Stay tuned for more detail.
To help Texas physicians safely and effectively treat patients during the COVID-19 pandemic, several changes to telemedicine visits have taken effect, including payment for services and which platforms can be used.
Have you talked to your patients about voluntary advance care planning? Did you know that Medicare will pay for those discussions as either a separate Part B medically necessary service or an optional element of a patient’s annual wellness visit?
Do you have questions and need quick answers? Contact Novitas Solutions with questions.
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You can also contact the TMA Knowledge Center at (800) 880-7955.
If a patient is a Medicare beneficiary, can you bill Medicare for the routine task of drawing a blood sample? The answer: It depends.
The Latest COVID-19 Relief Bill: Hits and Misses for MedicineThe third major COVID-19 relief measure includes promising funding for a variety of important health measures in Texas. But there’s also the prospect of a Medicare physician payment cut.
Support Medicare Payment Parity for Another Year, TMA Tells LawmakersThe Texas Medical Association is calling on Texas’ federal lawmakers to support a measure that would prevent Medicare from cutting payments to certain specialties for a year.
The Low-Down on Looking Up Medicare MBIsNow that Medicare has begun replacing patients’ Health Insurance Claim Numbers (HICN) with the Medicare Beneficiary Identifier (MBI), you might be wondering how you’ll find those MBIs.
Can’t Say It Enough: Document, Document, DocumentWhen Medicare delves into claims errors, one stands out above the rest: insufficient documentation.
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.
Ways to Avoid a Medicare AppealNovitas 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-toUnclear about exactly what information a Medicare hospice certification or recertification form must contain? CMS offers guidance on essential elements the form must have.
Got Medicare questions? Call the Knowledge Center.
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TMA’s free Reimbursement Review and Resolution Service (formerly known as the Hassle Factor Log) goes to bat for members by helping to resolve issues related to insurance payments. TMA can help resolve issues with your payer network status, prompt-pay, and other reimbursement claims.
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Use TMA’s free tool to screen physicians from whom you receive order/referrals to make sure they are enrolled in the Medicare program.
More than ten million Medicare beneficiaries currently receive their Medicare coverage through Medicare Advantage (MA); a program in which Medicare contracts with and pays private health plans to provide coverage for Medicare benefits.