Thursday, August 24, 2023
- 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?
- HCPCS Application Summaries & Coding Decisions: Non-Drug & Non-Biological Items & Services
- New Place of Service Code 27 – Outreach Site/Street
- ICD-10 Coordination & Maintenance Committee Meeting — September 12–13
- Optimizing Healthcare Delivery to Improve Patient Lives Conference — November 15
- Clinical Laboratory Fee Schedule & Laboratory Services Reasonable Charge Payment: Quarterly Update
- Activation of Validation Edits for Providers with Multiple Service Locations — Revised
News
Seasonal Flu Vaccine Pricing for 2023–2024 Season
Get payment allowances and effective dates for the 2023–2024 season.
More Information:
- Flu Shot webpage: frequency, coverage, billing, coding, and resources
- Instruction to your Medicare Administrative Contractor
Expanded Home Health Value-Based Purchasing Model: July 2023 Interim Performance Reports, Post-Event Materials, & Comment on CY 2024 Proposals
Download your final July 2023 Interim Performance Report (IPR) from iQIES. See instructions for accessing reports.
For the CY 2023 performance year, you’ll get a report if you:
- Were Medicare-certified prior to January 1, 2022
- Have enough data for at least 1 quality measure
More Information:
- Materials from the July 27 IPR Overview call:
- Expanded Home Health Value-Based Purchasing Model (HHVBP) webpage: See Model Reports Section
- QIES/iQIES Service Center at 800-339-9313 or iqies@cms.hhs.gov: Register a user, or get help locating or downloading reports
Comment on proposed changes to the expanded HHVBP Model in the CY 2024 Home Health Prospective Payment System proposed rule by August 29.
Behavioral Health Integration Services: Are Your Patients Eligible?
Behavioral health integration (BHI), incorporating behavioral health care with primary care, is an effective strategy to improve mental, behavioral, or psychiatric health for many patients.
Your patients may be eligible for BHI services. Eligible conditions include:
- Mental health
- Behavioral health, including substance use disorder
- Psychiatric
Medicare covers 2 types of BHI services:
- Psychiatric Collaborative Care Model (CoCM): Use CPT codes 99492–99494 and HCPCS code G2214 to bill
- General BHI services using models of care other than CoCM: Use CPT code 99484 and HCPCS code G0323 to bill
We make separate payment to physicians and non-physician practitioners for services they supply to patients over a calendar month service period.
Read Behavioral Health Integration Services to learn more.
More Information:
- Addressing & Improving Behavioral Health webpage
- Care Management webpage
Claims, Pricers, & Codes
HCPCS Application Summaries & Coding Decisions: Non-Drug & Non-Biological Items & Services
CMS published the First Biannual 2023 HCPCS Application Summaries & Coding Recommendations for non-drug and non-biological items & services. See HCPCS Level II Coding Decisions for more information.
New Place of Service Code 27 – Outreach Site/Street
The Place of Service Committee recently created new place of service code 27, Outreach Site/Street, which will be effective October 1, 2023. At this time, Medicare won’t use this code in claims processing. If you submit a claim with this code, we’ll return it to you. See the instruction to your Medicare Administrative Contractor for more information.
Events
ICD-10 Coordination & Maintenance Committee Meeting — September 12–13
Tuesday, September 12 – Wednesday, September 13 from 9am – 5pm ET
You must register for this virtual meeting if you want to attend.
More Information:
Optimizing Healthcare Delivery to Improve Patient Lives Conference — November 15
Wednesday, November 15 from 9am – 4pm ET
Register for this virtual conference.
Join leadership from federal government, health provider organizations, and the patient advocacy community to focus on opportunities across the healthcare enterprise to:
- Reduce administrative burden
- Strengthen access to quality care
- Make it easier for clinicians to provide care
MLN Matters® Articles
Clinical Laboratory Fee Schedule & Laboratory Services Reasonable Charge Payment: Quarterly Update
Learn about updates for laboratory billing:
- Private payor data reporting: You must report data between January – March 2024
- General specimen collection fee increase
- New and deleted HCPCS codes
Activation of Validation Edits for Providers with Multiple Service Locations — Revised
CMS added new information about the practice location address screen.
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