Starting January 5, 2015, the “Medicare Treatment Authorization” field must contain blanks or valid Medicare data in the first 14 bytes of the treatment authorization… Read More »Proper use of ‘Medicare Treatment Authorization’ field
Payment rates for an individual service are based on the following three components: 1) Relative Value Units (RVU); 2) Conversion Factor (CF); and 3) Geographic… Read More »How to calculate Medicare Fee Schedule?
Effective August 1, 2012, if you have not yet converted from the 4010A1 format of the electronic remittance advice, the Medicare Fee-For-Service (FFS) program will… Read More »Medicare will Automatically Convert Format 4010A1 Electronic Remittance Advice (835) to X12 Version 5010 Effective August 1, 2012
The Medicare regulations at 42 Code of Federal Regulations (CFR), Section 424.44, specify the time limits for filing Part A and Part B Fee-For-Service claims.… Read More »Medicare Timely Filing Exceptions
Limiting charges were established by CMS to limit the amount a non-participating provider can charge a beneficiary for a non-assigned service. In other words, this is… Read More »What is limiting charge with Medicare?
“Incident to” is a benefit category that allows Medicare to reimburse physicians for physician services as though the physician personally performed the service, when the service… Read More »What is ‘Incident To’?