tci Medicare Compliance & Reimbursement - 2003 Issue 22

PROGRAM MEMO ROUNDUP

Providers and contractors alike have been confused about certain elements of billing for diabetes outpatient self-management training (DSMT), but recent guidance from the Centers for Medicare & Medicaid Services should set the record straight. In program memorandum B-03-043 (http://cms.hhs.gov/manuals/pm_trans/A03043.pdf), CMS clarifies that "incident to" supervision rules and other "incident to" requirements do not apply to DSMT services. The agency explains that the legislation that authorizes DSMT payments does so in a "stand alone" provision that is not subject to the separately outlined incident-to requirements. In other recent program memoranda, CMS: explains its position on the implementation...

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