Medicare

How Health Plans Are Covering COVID-19 Testing and Treatment

 

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.

COVID-19 and Health Plans: What's Covered?  

COVID-19 Medicare Resources

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

Telemedicine Payments Promised, Regulations Eased

 

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. 

See What Changes Have Been Made to Medicare  

TMA Says “No” to Federal Scope Expansion Under President’s Medicare Executive Order

 

President Donald Trump’s recent executive order on Medicare includes scope-of-practice language that is raising concerns among Texas physicians – including the president of the Texas Medical Association.

Read TMA's Concerns  

Submit 2019 QPP Data by March 31 to Avoid a 7% Medicare Payment Cut

 

The data submission period for Medicare’s 2019 Quality Payment Program (QPP) is under way and closes on March 31. If you haven’t started the process, now is the time to ensure your data for the Merit-Based Incentive Payment System (MIPS) is in order and submit it in time to make corrections by the deadline, if needed.

Get the Details

Fix Medicare Now, TMA Tells Feds

 

Unless the federal government increases physicians’ Medicare payments and overhauls Medicare’s hassle-laden Quality Payment Program (QPP), access to health care for millions of American seniors and people with disabilities “is at risk,” the Texas Medical Association told Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma.

More on This Unsustainable Trend  

Get Paid for End-of-Life Care Discussions With Patients

 

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? 

Get the Details  

Medicare Inquiries

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

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

You can also contact the TMA Knowledge Center at (800) 880-7955.

Medicare Lab Fee Includes Routine Venipuncture

 

If a patient is a Medicare beneficiary, can you bill Medicare for the routine task of drawing a blood sample? 
The answer: It depends.

Get the Details  

75 Ways the Big Medicare Changes Are Very Bad for Physicians and Patients

 

Exactly two months ago, the Centers for Medicare & Medicaid Services unveiled a massive package of proposed new rules for the Medicare program with the promise that it would “increase the amount of time that doctors and other clinicians can spend with their patients by reducing the burden of paperwork that clinicians face when billing Medicare.”

Read TMA's Painstakingly Detailed Comment Letter  

Three Things to Know About the New Medicare Cards

 

New Railroad Retirement Board Medicare cards are in the mail, and new Medicare cards for Texans will “mail soon,” according to the Centers for Medicare & Medicaid Services. Here are three things to know about the new cards and the new Medicare Beneficiary Identifier.

Learn More

Current Medicare News

The Low-Down on Looking Up Medicare MBIs
Now 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.

On Their Way: New Medicare Patient ID Numbers
The New Medicare Card project is part of the Medicare Access and CHIP Reauthorization Act (MACRA) and requires CMS to remove the Social Security number from Medicare cards out of concerns over identity theft.

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.