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Thursday, November 9, 2023



Claims, Pricers, & Codes


MLN Matters® Articles





CMS Roundup (Nov 3, 2023)

You may be interested in these topics from the CMS Roundup:

  • Strategy to Promote Health Equity for Underserved Populations
  • Blog Outlines CMS’ Role Related to HHS Proposed Rule to Address Information Blocking


Marriage and Family Therapists & Mental Health Counselors: Enroll in Medicare Now

CMS will implement 2 new provider types on January 1:

  1. Marriage and family therapist
  2. Mental health counselor

You must enroll in Medicare to submit claims, and get paid for covered items or services. Enroll now. Find out how to become a Medicare provider, and take these steps to enroll:

Your effective enrollment date won’t be earlier than January 1.

More Information:


American Indians or Alaska Natives: Help Your Patients Achieve Optimal Health

Among American Indians or Alaska Natives:

  • Leading diseases and causes of death include heart disease, cancer, diabetes, and stroke (see HHS Office of Minority Health)
  • There are higher rates of obesity and smoking cigarettes (see CDC)

During Native American Heritage Month, help address the unique health care challenges facing this community, and recommend preventive services.

Medicare pays for preventive services. Find out when your patient is eligible (PDF). If you need help, contact your eligibility service provider.

More Information:


Claims, Pricers, & Codes


Home Health Prospective Payment System Grouper: January Update

Get the January 2024 release (v05.0.24) (ZIP). See Home Health Prospective Payment System Grouper Software for a summary of changes.

More Information:




CMS Hospice Forum — November 14

Tuesday, November 14 from 1–2 pm ET

Register for this webinar.

Learn about hospice updates from the CY 2024 Home Health Prospective Payment System final rule, including:

  • Informal dispute resolution process
  • Hospice Special Focus Program, including selection, public reporting, enforcement, completion, and termination


Optimizing Healthcare Delivery to Improve Patient Lives Conference — November 15

Wednesday, November 15 from 9 am – 4 pm 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

More Information:


HCPCS Public Meeting — November 28–30

Tuesday, November 28 – Thursday, November 30 from 9 am – 5 pm ET

Attend a virtual public meeting for the second biannual 2023 HCPCS coding cycle. Visit the Downloads Section of HCPCS Public Meetings for more information, including:


Inpatient Rehabilitation Facility Prospective Payment System: Coverage Requirements Webinar — November 29

Wednesday, November 29 from 1:30–2:30 pm ET

Register for this webinar.

During this webinar, CMS will:

  • Review Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS) coverage requirements from pre-admission to discharge
  • Provide a refresher on existing payment requirements and answer common IRF PPS Helpdesk questions

After the webinar, we’ll post a recording on the IRF PPS webpage.


MLN Matters® Articles


ICD-10 & Other Coding Revisions to National Coverage Determinations: April 2024 Update

Learn about the April update. See MLN Matters Articles 13390 (PDF) and 13391 (PDF) for:

  • New codes
  • Recent changes
  • How to find coding information


Removal of a National Coverage Determination & Expansion of Coverage of Colorectal Cancer Screening — Revised

Learn who should apply the -KX modifier (PDF) for screening colonoscopy in the context of a complete colorectal cancer screening.




Home Health & Hospice Resources

Medicare covers a wide range of home health and hospice services. During Home Care & Hospice Month, get familiar with these Medicare Learning Network resources:

Information for Patients:


Independent Diagnostic Testing Facility — Revised  

Learn what’s changed (PDF), including information about:

  • Supervising physicians
  • Interpreting physicians
  • Technicians

CMS changed this link. If you previously bookmarked it, update your link.

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