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 get ready for the changes.
- CMS Information on MACRA
- Questions and Answers about MACRA from ACP
- MACRA News from ACP
- Positioning Your Practice for a New Payment System (ACP Internist, Jan. 2016)
- ACP's Recommendations to Congress about Implementing the New Payment System (The ACP Advocate, Dec. 4, 2015)
- What You Should Know About Alternative Payment Models (ACP Advocate, June 12, 2015)
- What to Expect in the Post-SGR Era (ACP Advocate, May 8, 2015)
Additional Payment Issues under Medicare
How to Comply with Medicare Regulations
- Advanced Care Planning Tool Kit: This tool kit helps practices implement and bill for Advanced 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:
- The ABCs of the Initial Preventive Physical Exam and the Annual Wellness Visit (CMS National Provider Call, July 21, 2011) Slides
- "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.
- 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)
Medicare Part D Resources
Where We Stand
From the ACA to Medicare reform, ACP is advocating for internists and their patients on issues we care about.
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