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Thursday, October 19, 2023



Claims, Pricers, & Codes


MLN Matters® Articles


From Our Federal Partners



2024 Medicare Parts A & B Premiums and Deductibles

On October 12, CMS released the 2024 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2024 Medicare Part D income-related monthly adjustment amounts.

Medicare Part B

The annual deductible for all Medicare Part B beneficiaries will be $240 in 2024, an increase of $14 from the annual deductible of $226 in 2023.

Medicare Part A Inpatient Hospital

The Medicare Part A inpatient deductible that beneficiaries pay if admitted to the hospital will be $1,632 in 2024, an increase of $32 from $1,600 in 2023. The Part A inpatient hospital deductible covers beneficiaries’ share of costs for the first 60 days of Medicare-covered inpatient hospital care in a benefit period.

In 2024, beneficiaries must pay a coinsurance amount of:

  • $408 per day for the 61st through 90th day of a hospitalization ($400 in 2023) in a benefit period
  • $816 per day for lifetime reserve days ($800 in 2023).

Skilled Nursing Facility

For beneficiaries in skilled nursing facilities, the daily coinsurance for days 21 through 100 of extended care services in a benefit period will be $204.00 in 2024 ($200.00 in 2023).

The Medicare Savings Programs (MSPs) help more than 10 million people with coverage of Medicare premiums and, in most cases, other cost sharing.

See the full fact sheet for more information.

Help CMS Improve Provider Resources — Respond by November 9

CMS is conducting a study to help us improve your experience with Medicare program and billing resources. Share your thoughts with us by taking this survey by November 9. Responses are confidential, and the survey should take about 10 minutes to complete. Thank you for your time and valuable feedback.

CMS Health Information Handler Helps You Submit Medical Review Documentation Electronically

Learn about the CMS Health Information Handler (CMS HIH), a free service to help you upload and submit your medical documentation electronically to your Medicare Administrative Contractor using the following formats:

  • Portable document format (PDF)
  • Extensible markup language (XML)
  • JavaScript object notation (JSON)

Respond electronically to prior authorization and additional document requests: 

  • Unlimited number of transactions
  • Fast, safe, and secure environment
  • Easily accessible

The benefits of the CMS HIH include:

  • Hosted on CMS Amazon Web Services cloud
  • Adheres to all CMS security and privacy standards
  • Accommodates small or large users

Contact cmshih@cms.hhs.gov to learn more, and get started.


Health Literacy: Help Your Patients Get Information & Services

People with low health literacy are more likely to have poor health outcomes (see National Library of Medicine). They may have trouble:

  • Understanding medication instructions
  • Managing their chronic diseases
  • Getting preventive services

During Health Literacy Month, find out how to improve access to information and services, and help your patients make informed decisions.

More Information:

Claims, Pricers, & Codes

Discarded Drugs & Biologicals: When to Use JW & JZ Modifiers 

Read updated JW and JZ Modifier FAQs for additional clarity on billing with these modifiers (see FAQs 7, 8, and 18–22). CMS posted a new list of billing and payment codes only used for single-dose containers that may require the modifiers, depending on the setting:

  • We plan to update the list semi-annually
  • Note: The list doesn’t include all drugs subject to the JW and JZ modifier policy


Provider Compliance Focus Group Meeting — November 2 

Thursday, November 2 from 1–3:30 pm ET

Register for this meeting.

How can CMS improve our processes and eliminate unnecessary requirements for medical review and prior authorization? Join us, and let us know.

Target audience: physicians, non-physician practitioners, billing specialists, suppliers, associations, coders, and medical review contractors.

Expanded Home Health Value-Based Purchasing Model: Preparing for CYs 2024 & 2025 Webinar — November 9 

Thursday, November 9 from 2–3 pm ET

Register for this webinar.

CMS will review the CY 2024 Home Health Prospective Payment System final rule and how it applies to the Expanded Home Health Value-Based Purchasing Model.


MLN Matters® Articles

Update for Blood Clotting Factor Add-on Payments 

Learn about changes to blood clotting factor add-on payments:

  • Additional eligible diagnosis codes
  • Adjustment of certain claims with these codes



Complying with Medical Record Documentation Requirements — Revised

Learn what’s changed, including examples of documentation you can provide to support your Medicare claims.

Expanded Home Health Value-Based Purchasing Model Resource Index — Updated 

CMS updated the Resource Index to help you understand and participate in the Expanded Home Health Value-Based Purchasing Model.

From Our Federal Partners

Health Care Preparedness Resources 

The Administration for Strategic Preparedness and Response's Technical Resources, Assistance Center, and Information Exchange (ASPR TRACIE) released new health care preparedness resources:

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