Change to Processing for Telehealth Services Billed with POS 10
Date: February 23, 2024
In calendar year (CY) 2024, the Centers for Medicare & Medicaid Services (CMS) issued a change to processing for telehealth services billed with POS 10. As of 1/1/2024, these claims are to be paid at the nonfacility physician fee schedule (PFS) rate. A system processing issue resulted in incorrect payments at the facility rate, which has now been corrected. As per CMS instructions issued 2/21/2024, National Government Services (NGS) will initiate a mass adjustment of all impacted claims with dates of service 1/1/2024 and after. No provider action is necessary at this time.
Please continue to monitor this site for additional updates.
Recent News
Code Implementation Dates
Last week the AMA published information about several important coding and billing updates that will affect claims submission, and compliance in your practice and ASC. ...
Properly Billing for Intravitreal Injections with E/M Code 99211-99215 and Modifier 25
CMS TPE audits of intravitreal injections and the accompanying office visit continue. Practices involved in these reviews often question what auditors are looking for. These reviews ...
Medicare Contractor WPS Incorporates ASCRS/AAO Recommendations on Proposed Local Coverage Determination for Cataract Surgery
Medicare Administrative Contractor (MAC) Wisconsin Physicians Service Insurance Corporation (WPS) released its final version of the LCD. In this edition, WPS brings the proposed LCD ...
iDose New Permanent J code
In December 2023, the US Food and Drug Administration approved iDose TR for a single administration per eye intracameral implant that continuously releases travoprost, indicated for ...
Federal Trade Commission Eyeglass Rule
Concluding a comprehensive multi-year review, the Federal Trade Commission (FTC) has announced final updates to its Ophthalmic Practice Rules, known as the Eyeglass Rule, aimed at ...
CMS Extends Deadline for MIPS 2023 Data Submission
CMS has extended the data submission period for the Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2023 performance year of the ...
Congress Passed bill for MPFS
The recent passing of a partial government funding bill by Congress on March 8 is important to Medicare beneficiaries. This bill includes policies aimed at addressing ...
Diabetes Cost Measure Misattributed to Ophthalmologists
The American Society of Cataract and Refractive Surgery (ASCRS), the American Society of Retina Specialists (ASRS) and the American Academy of Ophthalmology (AAO), met recently ...
Review Your 2022 MIPS Performance Feedback and Final Scores
The Centers for Medicare & Medicaid Services (CMS) has released the Merit-Based Incentive Payment System (MIPS) performance feedback and final scores for the 2022 performance ...
JZ Modifier Required July 1, 2023
The much-anticipated mandatory reporting of the JZ modifier for Part B Medicare begins July 1, 2023. The new Medicare policy can be found here. The ...
Cigna Hits the Brakes on Their New Modifier 25 Policy
Following fierce opposition from the physician community, the insurer Cigna announced today a delay in implementing a policy (PDF) that would have required submitting medical ...
Medical Consulting Group and Corcoran Consulting Group Announce Merger
Springfield, MO, April 27th, 2023. Medical Consulting Group (MCG), a provider of consulting services to ophthalmic practices and companies, and Corcoran Consulting Group (CCG), a ...
IHEEZO Gel gains Medicare Pass-Through
On March 13, 2023, Harrow® announced that the Centers for Medicare & Medicaid Services (CMS) has approved transitional pass-through reimbursement status for chloroprocaine hydrochloride ophthalmic ...
Cigna Change Modifier 25 Policy
As a result of a recent review, Cigna has announced it will require the submission of office notes with claims submitted for evaluation and management ...
Congress makes positive adjustments that affect ophthalmologists
In this Healio Video Perspective from Hawaiian Eye 2023, Kevin J. Corcoran, COE, CPC, CPMA, FNAO, discusses ophthalmic economic and regulatory updates for the year. ...