The Centers for Medicare & Medicaid Services (CMS) has issued Change Request 12424, which updates chapter 10 of the Medicare Claims Processing Manual to include additional instructions for submitting home health Notices of Admission (NOAs).
The Medicare Part B payment allowance limits for seasonal influenza (flu) vaccines are 95% of the Average Wholesale Price (AWP), except when the vaccine is given in a hospital outpatient department, rural health clinic (RHC) or federally qualified health center (FQHC). Payment is based on reasonable cost for these 3 places.
By November 1, 2021, the U.S. Centers for Medicare & Medicaid Services (CMS) will begin reprocessing claims for outpatient clinic visit services provided at excepted off-campus Provider-Based Departments (PBDs) so they’re paid at the same rate as non-excepted off-campus PBDs for those services under the Medicare Physician Fee Schedule (PFS).
