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.
CMS To Reprocess Certain Claims For Outpatient Clinic Visit Services
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).
AMA Releases 2022 CPT Code Set
The American Medical Association (AMA) released updates to the Current Procedural Terminology (CPT) code set for 2022. The new code set aims to streamline reporting and tracking of COVID-19 reporting, among other updates.
Medicare Reimbursement Announced For Third Dose Of COVID-19 Vaccine For Immunocompromised Individuals
The U.S. Food and Drug Administration (FDA) amended the emergency use authorizations for both the Pfizer-BioNTech and the Moderna COVID-19 vaccines to allow for the use of an additional dose in certain immunocompromised individuals, especially solid organ transplant recipients or those who are diagnosed with conditions that are considered to have an equivalent level of immunocompromise on August 12, 2021.
Rethinking Outsourced Medical Coding in a Pandemic: Benefits, Best Practices, and Considerations
The pandemic “changed everything”—and “everything” should include how you answer, “should we outsource medical coding services”?
