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We understand the challenges of keeping current on how to appropriately bill and code for your Medicare patients. Below are a number of resources to help you ensure that you are paid appropriately and are not in violation of any Medicare policies.
Getting Started with Medicare
- Medicare Enrollment Resources
- Web-based Training (WBT) Courses: Free tools from CMS that allow physicians and their staff to learn about a broad range of Medicare related issues.
- Opting out of Medicare and/or Electing to Order and Refer Services
- Additional information on Ordering and Referring from the AMA: Ordering/Referring Fact Sheet
The Medicare Access and CHIP Reauthorization Act of 2015 provides a more stable payment system for physicians while transitioning physicians away from a volume-based system toward one that rewards value. Learn more about the law and what physicians need to do to prepare for the changes.Learn more
Additional Payment Issues under Medicare
- Summary of the Medicare Physician Fee Schedule Rule for 2016
- Frequently-Asked-Questions (FAQs) Regarding the Centers for Medicare and Medicaid Services (CMS) Release of Physician Payment Data
- Physician Claims under Sequestration Rules for Medicare
- Telehealth Fact Sheet: Telehealth is reimbursed for services provided to patients in a Health Professional Shortage Area or in a county that is outside of any Metropolitan Statistical Area using real-time audio and video technology.
How to Comply with Medicare Regulations
- Advance Care Planning Tool Kit: This tool kit helps practices implement and bill for Advance Care Planning and end-of-life discussions.
- Chronic Care Management (CCM) Tool Kit: This new tool kit provides what practices need to implement the new CCM codes, including background information for clinicians and staff, a step-by-step implementation guide, and a sample patient agreement.
- Transition Care Management Codes: How to bill for the non-face-to-face care provided when patients transition from an acute care setting.
- Preventive Care Visits:
- "Welcome to Medicare" Exam
- Annual Wellness Visit
- IPPE and AWV FAQs
- Guide to Medicare Preventive Services Codes & Billing Information: This is an interactive PDF, in which you can click on a service at the left to view that service's information. Please note: some browsers may not display this file properly.
- CMS Provider Minute: Preventive Services: This short video explains proper billing and documentation for preventive services.
- Home Health Face-to-Face Encounter Requirement
- Care Plan Oversight Encounter Worksheet and Instructions (ACP login required) (may need updating)
- Value Based Payment Program
- Medicare Improper Payment Review
- Advanced Beneficiary Notices (ABN)