Program_Memos / 2002 / AB-02-136

Why This Topic Matters

It helps readers understand which Medicare-administered item categories were subject to charge updates and how the accompanying billing and payment policy changes were to be implemented. The memorandum also signals operational changes that affect claims processing, supplier education, and jurisdiction-specific handling.

Article Sections

1. Reasonable charge update overview

   Introduces the Medicare payment update framework for selected item categories and the general timing used to establish the updated charge amounts.

2. Codes subject to the reasonable charge update

   Lists the HCPCS items grouped by jurisdiction that are included in the update process across multiple supply and equipment categories.

3. AX Modifier

   Describes the introduction of a new modifier and the related billing update for certain dialysis-related supplies and equipment.

4. Gap-filling

   Summarizes the gap-filling framework used when charge data is incomplete or unavailable and identifies newly effective supply items addressed by that process.

5. Implementation

   Covers the operational steps for carriers and DMERCs to apply the updated payment amounts and notify suppliers about billing changes.

6. Education

   States the communication requirements for publishing the memorandum information to suppliers through bulletins and websites.