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Thursday, February 1, 2024



Claims, Pricers, & Codes





Participation Continues to Grow in CMS’ Accountable Care Organization Initiatives in 2024

CMS announced increased participation in CMS’ accountable care organization (ACO) initiatives in 2024, which will increase the quality of care for more people with Medicare. Of note, CMS is announcing that 19 newly formed ACOs in the Medicare Shared Savings Program (Shared Savings Program) are participating in a new, permanent payment option beginning in 2024 that is enabling these ACOs to receive more than $20 million in advance investment payments for caring for underserved populations. An additional 50 ACOs are new to the program in 2024, and 71 ACOs renewed their participation, bringing the total to 480 ACOs now participating in the Shared Savings Program, the largest ACO program in the country. CMS also announced that 245 organizations are continuing their participation in two CMS Innovation Center models — ACO Realizing Equity, Access, and Community Health and the Kidney Care Choices models.

See the full press release

CMS Roundup (Jan 26, 2024)

You may be interested in this topic from the CMS Roundup: Data to Drive Decision Making Cross-Cutting Initiative.


Claims, Pricers, & Codes

HCPCS Application Summaries & Coding Decisions: Drugs & Biologicals 

CMS published the 2023 HCPCS Application Summary for Quarter 4, 2023 Drugs and Biologicals. See HCPCS Level II Coding Decisions for more information.

Medicare Physician Fee Schedule: New CPT Codes for RSV Vaccine Administration

CMS retroactively added 2 new CPT codes for respiratory syncytial virus (RSV) vaccine administration to the Medicare Physician Fee Schedule files effective for dates of service on and after October 6, 2023: 

  • 96380 – Short descriptor: Admn rsv monoc antb im cnsl
  • 96381 – Short descriptor: Admn rsv monoc antb im njx

Get RSV shot information for your patients.



Medicare Cost Report E-Filing System Webinar — February 14

Wednesday, February 14 from 1–2:30 pm ET

Register for this webinar.

Target Audience: 

  • Medicare Part A providers 
  • Entities that file cost reports for providers 

Learn about new and upcoming functionality for Medicare Part A cost reports in the Medicare Cost Report E-Filing (MCReF) system: 

  • Download provider and statistical reimbursement summary reports
  • Use optional electronic cost report exhibit templates to get immediate feedback about potential issues, along with faster acceptance and tentative settlement; see new exhibit templates for:
    • Medicare bad debt listing
    • Medicaid eligible days
    • Charity care charges
    • Total bad debt 

You may send questions in advance to OFMDPAOQuestions@cms.hhs.gov with “MCReF Webinar” in the subject line. We’ll answer your questions during the webinar, or use them to develop educational materials.



Medicare Provider Enrollment — Revised

Learn what’s changed:

  • Updated the enrollment application fee amount for 2024 
  • Merged Form CMS-855R into the CMS-855I paper enrollment application
  • Added:
    • Marriage and family therapists, mental health counselors, and certain dental specialties to the Part B suppliers list 
    • New provider specialty code information for dentists

Practitioner & DMEPOS Supplier Information on Power Mobility Devices — Revised

Learn what’s changed (PDF)CMS added information about newly covered power seat elevation equipment for certain power wheelchairs.


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