Resource MLN Connects Newsletter

MLN Connects® Newsletter​

Get the Latest Info from CMS GOV

Subscribe to our weekly email newsletter for health care providers. Our staff compiles news from across CMS into your single source for:

• Program and policy details
• News and announcements
• Press releases
• Upcoming educational event registration and reminders
• Claim, pricer, and code information
• Updates on new and revised MLN Matters Articles® and publications

MLN Connects® Newsletter | CMS

For Medicare FFS providers: Read the MLN Connects newsletter to learn about Medicare payment, policy, coding, compliance, and preventive services.

www.cms.gov

 

[Lori]

Thursday, May 4, 2023​

News​ FAQs on CMS Waivers, Flexibilities, and the End of the COVID-19 Public Health Emergency Guidance for the Expiration of the COVID-19 Public Health Emergency COVID-19 Over-the-Counter Tests Medicare Diabetes Prevention Program: Public Health Emergency Flexibilities Continue through December 31 Transplant Eco-System: Role of Data in CMS Oversight of The Organ Procurement Organizations Expanded Home Health Value-Based Purchasing Model: April Newsletter & Performance Reports Religious Nonmedical Health Care Institution Benefit & COVID-19 Vaccines Clinical Laboratory Fee Schedule 2024 Preliminary Gapfill Rates: Submit Comments by June 26 Mental Health: Recommend Medicare Preventive Services Claims, Pricers, & Codes​ COVID-19: Reporting CR Modifier & DR Condition Code After Public Health Emergency Update Claim Status Category & Claim Status Codes Events​ Medicare Shared Savings Program: Navigating the Application Webinar — May 8 HCPCS Public Meeting — May 30 – June 1 MLN Matters® Articles​ New Fiscal Intermediary Shared System Edit to Validate Attending Provider NPI — Revised Publications​ Electronic Cell-Signaling Treatment

 

[Lori]

Thursday, May 11, 2023​

News​ CMS Roundup (May 5, 2023) Medicare Ground Ambulance Data Collection System: Report Information Compliance​ Bill Correctly: Power Mobility Devices Repairs MLN Matters® Articles​ Clinical Laboratory Fee Schedule & Laboratory Services Reasonable Charge Payment: Quarterly Update Home Dialysis Payment Adjustment & Performance Payment Adjustment for ESRD Treatment Choices Model: Updated Process Publications​ Billing Medicare Part B for Insulin with New Limits on Patient Monthly Coinsurance — Revised Expanded Home Health Value-Based Purchasing Model: Updated Measure Calculation Resources

 

[Lori]

Thursday, May 18, 2023​

News​ COVID-19: Public Health Emergency Ended May 11 End of COVID-19 Public Health Emergency FAQs Advancing Health Equity Through The CMS Innovation Center: First Year Progress And What’s To Come Power Seat Elevation Equipment on Power Wheelchairs: Coverage, Coding, & Payment Medicare Shared Savings Program: Apply for January 1 Start Date by June 15 Inpatient Rehabilitation Facility Services: Review Choice Demonstration Women’s Health: Talk with Your Patients About Making their Health a Priority Claims, Pricers, & Codes​ COVID-19: Reporting CR Modifier & DR Condition Code After Public Health Emergency — Reminder Events​ Skilled Nursing Facility: Minimum Data Set Resident Assessment Instrument Training Publications​ Screening Pap Tests & Pelvic Exams — Revised From Our Federal Partners​ Potential Risk for New Mpox Cases

 

[Lori]

Thursday, May 25, 2023​

News​ DMEPOS Competitive Bidding Program: Temporary Gap Period Starts January 1 CMS Roundup (May 19, 2023) Medicare Providers: Deadlines for Joining an Accountable Care Organization ESRD-Related Services: Comparative Billing Report in May Claims, Pricers, & Codes​ COVID-19 Pfizer-BioNTech & Moderna Vaccines: Product & Administration Code Updates MLN Matters® Articles​ Mental Health Visits via Telecommunications for Rural Health Clinics & Federally Qualified Health Centers — Revised Publications​ Checking Medicare Claim Status Multimedia​ J0510–J0530 Pain Interview: Understanding How a Patient Communicates Pain Video Information for Patients​ States Are Restarting Medicaid & CHIP Eligibility Reviews: Tell Your Patients to Prepare Now

 

[Lori]

Thursday, June 1, 2023​

News​ CMS Announces Plan to Ensure Availability of New Alzheimer’s Drugs COVID-19 Health Care Staff Vaccination Final Rule Medicare Secondary Payer Accident-Related Diagnosis Codes: How to Get Paid Hospitals: New Payment Adjustments for Domestic N95 Respirators Expanded Home Health Value-Based Purchasing Model: May Newsletter Improve Cognitive Health: Medicare Covers Services MLN Matters® Articles​ Ambulatory Surgical Center Payment System: July 2023 Update HCPCS Codes Used for Skilled Nursing Facility Consolidated Billing Enforcement: July 2023 Quarterly Update Updating Medicare Manual with Policy Changes in the CY 2020 & CY 2021 Final Rules Publications​ Medicare Preventive Services — Revised Medical Record Maintenance & Access Requirements — Revised Multimedia​ Hospice Quality Reporting Program Web-Based Training — Revised

 

[Lori]

Thursday, June 8, 2023​

News​ CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in the Territory of Guam Due to Recent Typhoon CMS Roundup (June 2, 2023) Gender-Specific Services: Billing Correctly and Usage of the Condition Code/Modifier Medicare Shared Savings Program: Apply for January 1 Start Date by June 15 Skilled Nursing Facility Value-Based Purchasing Program: June Feedback Report Short-Term Acute Care Hospitals: Program for Evaluating Payment Patterns Electronic Reports Medicare Providers: Deadlines for Joining an Accountable Care Organization Help Address Disparities in the LGBTQI+ Community Claims, Pricers, & Codes​ National Correct Coding Initiative: July Update Integrated Outpatient Code Editor: Version 24.2 MLN Matters® Articles​ Allowing Audiologists to Provide Certain Diagnostic Tests Without a Physician Order

 

[Lori]

Thursday, June 15, 2023​

News​ Inflation Reduction Act Continues to Lower Out-of-Pocket Prescription Drug Costs for Drugs with Price Increases Above Inflation CMS Announces Multi-State Initiative to Strengthen Primary Care Critical Access Hospitals: Annual Average Patient Length of Stay Requirement Skilled Nursing Facility Probe and Educate Review Billing Medicare Part B for Insulin with New Limits on Patient Monthly Coinsurance ESRD Prospective Payment System: July Update Medicare Learning Network Web Refresh Men’s Health: Encourage Your Patients to Prioritize Their Health Claims, Pricers, & Codes​ ICD-10-PCS Procedure Codes: FY 2024 MLN Matters® Articles​ DMEPOS Fee Schedule: July 2023 Quarterly Update Hospital Outpatient Prospective Payment System: July 2023 Update New JZ Claims Modifier for Certain Medicare Part B Drugs Ambulatory Surgical Center Payment System: July 2023 Update — Revised Publications​ Expanded Home Health Value-Based Purchasing Model: Resource Index, FAQs, & Specifications Information for Patients​ New Tools to Lower Prescription Drug Costs for Low-Income Seniors and People with Disabilities

 

[Lori]

Thursday, June 22, 2023​

News​ CMS Roundup (June 16, 2023) Lower Endoscopy: Comparative Billing Report in June Medicare Physician Fee Schedule Database: July Update Behavioral Health Integration Services: Get Information about the Codes Claims, Pricers, & Codes​ ICD-10-CM Diagnosis Codes: FY 2024 Events​ Expanded Home Health Value-Based Purchasing Model: Overview of the Interim Performance Report Webcast — July 27 MLN Matters® Articles​ New Waived Tests Home Dialysis Payment Adjustment & Performance Payment Adjustment for ESRD Treatment Choices Model: Updated Process — Revised

 

[Lori]

Thursday, June 29, 2023​

News​ CY 2024 ESRD Prospective Payment System Proposed Rule Transforming Medicare Coverage: A New Medicare Coverage Pathway for Emerging Technologies and Revamped Evidence Development Framework New Details of Plan to Cover New Alzheimer’s Drugs Model Participants for the Enhancing Oncology Model Hospital Price Transparency: Volunteer for Machine-Readable File Validator Testing Claims, Pricers, & Codes​ RARCs, CARCs, Medicare Remit Easy Print, & PC Print: July Update Events​ Hospital Price Transparency Machine-Readable File Sample Format Webinar — July 26 MLN Matters® Articles​ Ambulatory Surgical Center Payment System: July 2023 Update — Revised From Our Federal Partners​ Locally-Acquired Malaria Cases Identified in U.S. Measles Guidance for the Summer Travel Season Information for Patients​ States Are Restarting Medicaid & CHIP Eligibility Reviews: Tell Your Patients to Prepare Now

 

[Lori]

Thursday, July 6, 2023​

News​ CY 2024 Home Health Prospective Payment System Proposed Rule HHS Announces Actions to Lower Health Care Costs and Allow Medicare to Negotiate Lower Drug Prices CMS Roundup (June 30, 2023) Skilled Nursing Facility: COVID-19 Enforcement Discretion for Pharmacy Billing Ended June 30 Medicare Providers: Deadlines for Joining an Accountable Care Organization Help People with Disabilities Get the Care They Need MLN Matters® Articles​ Corrections to Home Health Claims Edits Publications​ Medicare & Mental Health Coverage — Revised From Our Federal Partners​ Wildfire Smoke Exposure Poses Threat to At-Risk Populations

 

[Lori]

Thursday, July 13, 2023​

News​ Hospital Outpatient Prospective Payment System: Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022 National Coverage Determination: Pre-exposure Prophylaxis Using Antiretroviral Drugs to Prevent HIV Infection Medicare Dental Services: Learn What’s Covered Claims, Pricers, & Codes​ Institutional Providers: Resubmit Audiology Claims Returned with Reason Code 34963 Inpatient Prospective Payment System-Excluded Hospitals: Correcting Issue with Excluded Units ICD-10-CM Diagnosis Codes: FY 2024 Coding Guidelines & Conversion Table Events​ Expanded Home Health Value-Based Purchasing Model: Overview of the Interim Performance Report Webcast — July 27 MLN Matters® Articles​ ICD-10 & Other Coding Revisions to Laboratory National Coverage Determinations: October 2023 Update Ambulatory Surgical Center Payment System: July 2023 Update — Revised New Fiscal Intermediary Shared System Edit to Validate Attending Provider NPI — Revised Publications & Multimedia​ Period of Enhanced Oversight for New Hospices in Arizona, California, Nevada, & Texas Expanded Home Health Value-Based Purchasing Model: New Resources From Our Federal Partners​ Rural Emergency Hospitals: Requirements in CMS Emergency Preparedness Final Rule

 

[Lori]

Thursday, July 13, 2023​

Proposed Rules​ CMS Physician Payment Rule Advances Health Equity CMS Proposes Policies to Expand Behavioral Health Access and Further Efforts to Increase Hospital Price Transparency

 

[Lori]

Thursday, July 20, 2023​

News​ Percutaneous Transluminal Angioplasty of Carotid Artery Concurrent with Stenting: Proposed National Coverage Determination Beta Amyloid Positron Emission Tomography in Dementia and Neurodegenerative Disease: Proposed National Coverage Determination CMS Posts Program Year 2022 Open Payments Data to CMS.gov Value-Based Insurance Design Model: CY 2024 DMEPOS Suppliers: When & Where to Submit Electronic Funds Transfer Authorization Agreement Form New Domestic N95 Respirator Payment Adjustments Medicare Providers: Deadlines for Joining an Accountable Care Organization Compliance​ Inpatient Admission Before Part A Entitlement: Bill Correctly MLN Matters® Articles​ Activation of Validation Edits for Providers with Multiple Service Locations — Revised Publications​ Telehealth Services — Revised Multimedia​ Post-Acute Care: Brief Interview for Mental Status Video

 

[Lori]

Thursday, July 27, 2023​

News​ CMS Continues Work on Behavioral Health Discarded Drugs and Biologicals: Updated FAQs on JW & JZ Modifiers Expanded Home Health Value-Based Purchasing Model: July 2023 Interim Performance Reports Subsequent Annual Wellness Visits: Comparative Billing Report in July Medicare Ground Ambulance Data Collection System: Submit Comments by September 11 Clinical Laboratories: New Diagnostic Tests & Reporting Reminder Viral Hepatitis: Talk with Your Patients about Shots & Screenings Claims, Pricers, & Codes​ HCPCS Application Summaries & Coding Decisions: Drugs & Biologicals From Our Federal Partners​ Biosimilars: Free Continuing Education Courses, Videos, & Resources from FDA

 

[Lori]

For the Week of July 31, 2023​

CARDIOLOGY​

What code is used to capture the removal and replacement of a leadless pacemaker?
READ THE ANSWER

LABORATORY​

Can you explain the differences between the Continuous Glucose Monitoring (CGM) codes?
READ THE ANSWER

RADIOLOGY​

Can we code multiple codes for a blood patch when injected in different levels?
READ THE ANSWER

RESPIRATORY​

Are the additional 30 minutes included with codes 95816-95822?
READ THE ANSWER

GENERAL​

Are intravenous injections provided through the same access line as fluids for an IV infusion separately billable?
READ THE ANSWER

 

[Lori]

Tuesday, August 1, 2023​

Final FY 2024 Payment Rules​ New CMS Rule Promotes High-Quality Care and Rewards Hospitals that Deliver High-Quality Care to Underserved Populations Hospice Payment Rate Update Medicare Inpatient Psychiatric Facility Prospective Payment System & Quality Reporting Inpatient Rehabilitation Facility Prospective Payment System Skilled Nursing Facility Prospective Payment System

 

[Lori]

Thursday, August 3, 2023​

News​ Medicare Dementia Care Model Your Patient’s Medicare Beneficiary Identifier (MBI) May Change CMS Roundup (July 28, 2023) Building on CMS's Accountable Care Vision to Improve Care for Medicare Beneficiaries Home Health Agencies & Partial Hospitalization Programs: Program for Evaluating Payment Patterns Electronic Reports Skilled Nursing Facility Value-Based Purchasing Program: August Performance Score Report Expanded Home Health Value-Based Purchasing Model: Revised July Interim Performance Reports MLN Matters® Articles​ ESRD Prospective Payment System: October 2023 Update Patient Driven Payment Model Claim Edits Processing Services During Disenrollment from the Program of All-Inclusive Care for the Elderly

 

[Lori]

Thursday, August 10, 2023​

News​ Immunization: Protect Your Patients Claims, Pricers, & Codes​ Outpatient Rehabilitation Claims with Reason Code W7072: Do You Need to Resubmit Claims? MLN Matters® Articles​ HCPCS Codes Used for Skilled Nursing Facility Consolidated Billing Enforcement: October 2023 Update Publications​ Expanded Home Health Value-Based Purchasing Model: New Resource & Updated FAQs Multimedia​ Skilled Nursing Facility: Minimum Data Set Resident Assessment Instrument Training Materials

 

[Lori]

Thursday, August 17, 2023​

News​ CMS.gov Website Refresh – Test Website Available for Feedback CMS Announces Resources and Flexibilities to Assist with the Public Health Emergency in Hawaii Due to Recent Wildfires Clotting Factor: CY 2024 Furnishing Fee Claims, Pricers, & Codes​ COVID-19: CPT Codes for Vaccines No Longer Authorized Inpatient Rehabilitation Facility Prospective Payment System: FY 2024 Pricer Update Skilled Nursing Facility Prospective Payment System: FY 2024 Pricer Update MLN Matters® Articles​ Hospice Payments: FY 2024 Update ICD-10 & Other Coding Revisions to National Coverage Determinations: January 2024 Update National Coverage Determination 30.3.3 – Acupuncture for Chronic Low Back Pain Power Seat Elevation Equipment on Power Wheelchairs Publications​ Medicare Provider Enrollment — Revised

 

[Lori]

Thursday, August 24, 2023​

News​ Seasonal Flu Vaccine Pricing for 2023–2024 Season Expanded Home Health Value-Based Purchasing Model: July 2023 Interim Performance Reports, Post-Event Materials, & Comment on CY 2024 Proposals Behavioral Health Integration Services: Are Your Patients Eligible? Claims, Pricers, & Codes​ HCPCS Application Summaries & Coding Decisions: Non-Drug & Non-Biological Items & Services New Place of Service Code 27 – Outreach Site/Street Events​ ICD-10 Coordination & Maintenance Committee Meeting — September 12–13 Optimizing Healthcare Delivery to Improve Patient Lives Conference – November 15 MLN Matters® Articles​ Clinical Laboratory Fee Schedule & Laboratory Services Reasonable Charge Payment: Quarterly Update Activation of Validation Edits for Providers with Multiple Service Locations — Revised