What Is Code J3590?

HCPCS J3490 (unclassified drug) and J3590 (unclassified biologic) are the HCPCS codes that are reported for medications that are biological but have not yet been established, to which the HCPCs code has been assigned. To report a new medicine that is biological and has been approved by the Food and Drug Administration with a specific…

Medicare Uncompensated Care Payments

Medicare Uncompensated Care Payments

CMS distributes a prospectively determined amount of uncompensated care payments to “Medicare disproportionate share hospitals” based on their relative share of uncompensated care nationally.  As required under law, this amount is equal to an estimate of 75 percent of what otherwise would have been paid as Medicare disproportionate share hospital payments, adjusted for the change…

COVID-19 Frequently Asked Questions (FAQs) – Released May 5, 2020

COVID-19 Frequently Asked Questions (FAQs) – Released May 5, 2020

CMS Releases Additional Medicaid & CHIP COVID-19 FAQs for State Medicaid and CHIP Agencies CMS released additional frequently asked questions (FAQs) to aid state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their response to the coronavirus disease 2019 (COVID-19) pandemic.  The new FAQs cover a variety of Medicaid and CHIP topics, including emergency…

MAC will Reprocess the claims – Telephone E&M; Visits

MAC will Reprocess the claims – Telephone E&M; Visits

The March 30 Interim Final Rule with Comment Period added coverage during the Public Health Emergency for audio-only telephone evaluation and management visits (CPT MAC codes 99441, 99442, and 99443) retroactive to March 1. On April 30, a new Physician Fee Schedule was implemented increasing the payment rate for these codes. Medicare Administrative Contractors (MACs) will…

CMS Announces Independent Commission to Address Safety and Quality in Nursing Homes

CMS Announces Independent Commission to Address Safety and Quality in Nursing Homes

As a part of President Trump’s Opening Up America Again effort, the Centers for Medicare & Medicaid Services (CMS) announced a new independent Commission that will conduct a comprehensive assessment of the nursing home response to the 2019 Novel Coronavirus (COVID-19) pandemic. The Commission will provide independent recommendations to the contractor to review and report…

Annual Updates for Flu Vaccine_2019-2020 – Season (Payment Allowance)

Annual Updates for Flu Vaccine_2019-2020 – Season (Payment Allowance)

This recurring update notification provides the availability of payment allowances for the seasonal influenza virus vaccines as updated on an annual basis, effective August 1 of each year. The Medicare Part B payment allowance limits for seasonal influenza and pneumococcal vaccines are 95% of the Average Wholesale Price (AWP) as reflected in the published compendia…