General Surgery Coding Alert - 2014 Issue 42
Part B Payment: CMS Outlines the 6 Conditions of Chronic Care Management Payment
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Article Overview
This article summarizes CMS guidance discussed on an Open Door Forum, including Part B payment updates, upcoming payment determinations for newly introduced drug screening CPT codes, chronic care management billing requirements, and a documentation change for Medicare home health certification. It is relevant for physicians, office staff, home health agencies, and other Medicare billing professionals who need to follow current CMS payment and documentation policy updates.
Why This Topic Matters
The article highlights Medicare policy and payment changes that affect how providers document, report, and qualify for reimbursement under Part B and home health-related services. It helps readers track CMS operational guidance and upcoming implementation changes.
Article Sections
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Part B payment updates and conversion factor timing
Discusses CMS pricing updates and the timing differences described for the Medicare conversion factor. It also notes broader payment-related announcements referenced during the forum.
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Payment considerations for new drug screening codes
Addresses CMS discussion of upcoming payment decisions for newly effective drug screen CPT codes and the process CMS uses to announce those decisions.
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CMS lays down CCM rules
Summarizes CMS’s chronic care management payment topic, including the general requirements CMS described for billing and service reporting under the new policy.
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Change your narrative
Covers the home health certification documentation update and the related Medicare educational event announced by CMS.
What You Will Learn
- How CMS described Part B payment timing changes
- How CMS is handling payment decisions for newly effective drug screening CPT codes
- What general conditions CMS associated with chronic care management payment
- What documentation change CMS made for home health certification
- Who the CMS education call is intended for
Who Should Read This
- Physicians
- Medical office billing staff
- Coders
- Home health agencies
- Skilled nursing facility discharge planners
- Non-physician practitioners
- Medicare compliance staff
Codes Discussed
Code Ranges Discussed
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