Medicare News


Medicare News includes information for health care professionals about Medicare programs, policies and initiatives. Use these resources to stay up-to-date about current and planned Medicare changes.

Palmetto GBA maintains links to recently released and revised Centers of Medicare & Medicaid Services (CMS) MLN® articles. All MLN Matters articles will continue to be available on the CMS MLN Matters website. MLN Connects® will contain Medicare related messages from CMS. These messages ensure planned, coordinated messages are delivered timely about Medicare related topics.




National Coverage Determination (NCD) 20.19 Ambulatory Blood Pressure Monitoring (ABPM)Ensure Required Patient Assessment Information for Home Health ClaimsAugust 2019 JM Home Health and Hospice Medicare AdvisoryOctober 2020 JM Home Health and Hospice Medicare AdvisoryRecent and Upcoming Improvements in Hospice Billing and Claims ProcessingDecember 2020 JM Home Health and Hospice Medicare AdvisoryInfluenza and Pneumonia Vaccinations in the Home Health or Hospice SettingNovember 2020 JM Home Health and Hospice Medicare AdvisoryAugust 2020 JM Home Health and Hospice Medicare AdvisoryJuly 2020 JM Home Health and Hospice Medicare AdvisoryHome Health Agencies (HHAs) Urged to Establish Access to the Internet Quality Improvement and Evaluation System (iQIES) By December 23, 2019What New Home Health Agencies (HHAs) Need to Know About Being Placed in a Provisional Period of Enhanced OversightJuly 2019 JM Home Health and Hospice Medicare AdvisoryJune 2020 JM Home Health and Hospice Medicare AdvisoryDecember 2019 JM Home Health and Hospice Medicare AdvisoryRedesign of Hospice Periods - Additional RequirementsSeptember 2020 JM Home Health and Hospice Medicare AdvisoryVBID Hospice Benefit Component Information Now AvailableAdvance Directives and the Home Health Plan of CarePatient Discharge Status and Patient Overlap StatusPeriodic Interim Payments (PIP) and Pass-Through Payment One-Day DelayAdditional Documentation Requests (ADRs) Can Be ConfusingCMS Provider Minute Videos for Part A and Part B Providers and DMEPOS SuppliersHow to Use the Medicare Coverage DatabaseReading An Institutional Remittance Advice (RA)How often does CMS update the Medicare Revalidation List due date information?Did You Know Putting Condition Code D9 on Your Claim Will Cause it to Suspend?Medicare Cost Report E-Filing (MCReF)Important Credit Balance (CMS-838) Report InformationPayments and Payment Adjustments under the Patient-Driven Groupings ModelAlpha-Numeric HCPCSRequest for Accelerated Payment InstructionMedicare Advantage (MA) Plans Adherence to Local and National Coverage Determination InquiriesMedicare Coverable Services for Integrative and Nonpharmacological Chronic Pain ManagementReduce Risk of Opioid Overdose Deaths by Avoiding and Reducing Co-Prescribing BenzodiazepinesOverview of the Patient Driven Groupings ModelAccepting Payment from Patients with a Medicare Set-Aside ArrangementCredit Balance Reports: Submission Tips Meeting CMS StandardsSubmit Medical Record Documentation via esMDIdentify a ProviderReminder on Billing Requirements Implemented for non-OPPS ProvidersPlease Do Not Email Protected Health Information (PHI)Local Coverage Determinations (LCDs)A Prescriber's Guide to the New Medicare Part D Opioid Overutilization Policies for 2019Medicare Advantage Plan Directory (CMS website)Medicare Plans to Modernize Payment Grouping and Code Editor SoftwareBilling for Services when Medicare is a Secondary PayerEntering Beneficiary Information: eServices Eligibility Inquiry vs. Claim SubmissionNew Medicare Card: HICN Claims Reject January 1, 2020Palmetto GBA to Consolidate Twitter AccountsPalmetto GBA Achieved a Capability Maturity Model Integration (CMMI) Maturity Level 4 RatingLivanta's Memorandum of Agreement (MOA) for Healthcare ProvidersImportant Tax Information - 1099 FormsBankruptcyLooking for Medicare Coverage Information?Unsolicited Fax or Email InquiryNew Requirements Added for Changing and Resetting Passwords in Direct Data Entry (DDE)Reminder of Advance Beneficiary Notice of Noncoverage (ABN) RenewalHow To Recognize an SMRC AuditContact Information on Medicare NoticesAre You Receiving Email updates from Palmetto GBA?2020 Medical Review (MR) Hot Topic Targeted Probe and Educate (TPE) Teleconference ScheduleRemittance Advice Resources and FAQs (CMS Product)Home Health ReferralsDurable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Part APromoting Interoperability (PI) ProgramsQuarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2021 UpdateSave Time with eTicketMedicare Diabetes Prevention Program Suppliers: Separate Medicare EnrollmentCertifying Patients for the Medicare Home Health BenefitCMS Open Payments Data WebsiteNew Medicare Beneficiary Identifier (MBI) Get It, Use ItThe Role of Therapy under the Home Health Patient-Driven Groupings Model (PDGM)Provider Self Service ApplicationsRepayment of COVID-19 Accelerated and Advance Payments Began on March 30, 2021Assisted Suicide Funding Restriction Act of 1997 (P.L. 105-12)Internet Quality Improvement and Evaluation System (iQIES) Known IssuesWaiver of Coinsurance and Deductible for Hepatitis B Preventive Service Vaccine Code, Section 4104 of the Patient Protection and Affordable Health Care Act (the Affordable Care Act), Removal of Barriers to Preventive Services in MedicareMLN Connects for Thursday, May 13, 2021Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print Update Home Health LUPA Threshold: Bill CorrectlyReplacing Home Health Requests for Anticipated Payment (RAPs) with a Notice of Admission (NOA) - Manual InstructionsJuly 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesQuarterly Update to Home Health (HH) GrouperJuly 2021 Integrated Outpatient Code Editor (I/OCE) Specifications Version 22.2July 2021 Update of the Hospital Outpatient Prospective Payment System (OPPS)Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - July 2021 UpdateMLN Connects Special Edition - Thursday, July 1, 2021July Quarterly Update for 2021 Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee ScheduleSection 50 in Chapter 30 of Publication (Pub.) 100-04 Manual UpdatesImplement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Health Care (CAQH) COREOctober 2021 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesMLN Connects Special Edition: Monday, August 2, 2021Update to Hospice Payment Rates, Hospice Cap, Hospice Wage Index and Hospice Pricer for FY 2022Biden-Harris Administration Takes Additional Action to Protect America's Nursing Home Residents from COVID-19Implement Operating Rules - Phase III Electronic Remittance Advice (ERA) Electronic Funds Transfer (EFT): Committee on Operating Rules for Information Exchange (CORE) 360 Uniform Use of Claim Adjustment Reason Codes (CARC), Remittance Advice Remark Codes (RARC) and Claim Adjustment Group Code (CAGC) Rule - Update from Council for Affordable Quality Health Care (CAQH) COREMedicare Fee-for-Service (FFS) Response to the Public Health Emergency on the Coronavirus (COVID-19)Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - October 2021 UpdateQuarterly Update to Home Health (HH) GrouperHome Health Notices of Admission - Additional Manual InstructionsOctober 2021 Integrated Outpatient Code Editor (I/OCE) Specifications Version 22.3October Quarterly Update for 2021 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee ScheduleOctober 2021 Update of the Hospital Outpatient Prospective Payment System (OPPS)Medicare Clarifies Recognition of Interstate License Compacts PathwaysJanuary 2022 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing FilesClaim Status Category and Claim Status Codes UpdateManual Updates for Clarification on the Election Statement Addendum and Extension of the Hospice Cap Calculation MethodologyMLN Connects for Thursday, November 4, 2021Modifications/Improvements to Value-Based Insurance Design (VBID) Model - ImplementationLow Utilization Payment Adjustment (LUPA) Add-on Amounts for Home Health (HH) Occupational Therapy Visits2022 Annual Update of Per-Beneficiary Threshold Amounts2022 Annual Update to the Therapy Code ListRemittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print UpdateHome Health Prospective Payment System (HH PPS) Rate Update for Calendar Year (CY) 2022Skilled Nursing Care and Skilled Therapy Services to Maintain Function or Prevent or Slow Decline: ReminderReduced Payment for Physical Therapy and Occupational Therapy Services Furnished in Whole or In Part by a Physical Therapist Assistant or an Occupational Therapy AssistantIncorporation of Recent Provider Enrollment Regulatory Changes into Chapter 10 of CMS Publication (Pub.) 100-08Calendar Year 2022 Update for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Fee ScheduleSummary of Policies in the Calendar Year (CY) 2022 Medicare Physician Fee Schedule (MPFS) Final Rule, Telehealth Originating Site Facility Fee Payment Amount and Telehealth Services List, CT Modifier Reduction List, and Preventive Services ListDirect Mailing Notification to Hospice Providers Regarding the Hospice Benefit Component, Value-Based Insurance Design (VBID) Model, Participating Medicare Advantage Organizations (MAOs)January 2022 Update of the Hospital Outpatient Prospective Payment System (OPPS)Provider ResponsibilityDiscontinuation of Common Working File (CWF) Eligibility Access for New Direct Data Entry (DDE) ID RequestsProvider Alert: Discontinuation of Common Working File Eligibility TransactionsDirect Mailing Notification to Hospice Providers Regarding the Hospice Benefit Component, Value-Based Insurance Design (VBID) Model, Participating Medicare Advantage Organizations (MAOs) Letter and ChecklistWays to Connect to Palmetto GBACY2022 Telehealth Update Medicare Physician Fee ScheduleMLN Connects for Thursday, February 17, 2022Quarterly Update to the Medicare Physician Fee Schedule Database (MPFSDB) - April 2022 UpdateMLN Connects Special Edition for Friday, February 18, 2022MLN Connects for Thursday, February 24, 2022Gap Billing Between Hospice TransfersMLN Connects for Thursday, March 3, 2022Internet-Only Manual Updates for Critical Care Evaluation and Management ServicesInternet Only Manual Update, Pub. 100-04, Chapter 11, Sections 20.1.4 and 30.3 Regarding the Cancellation of an Election and Billing for ServicesInternet-Only Manual Updates (IOM) for Critical Care, Split/ Shared Evaluation and Management Visits, Teaching Physicians, and Physician AssistantsMLN Connects for Thursday, March 10, 2022April Quarterly Update for 2022 Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Fee ScheduleMLN Connects for Thursday, March 17, 2022MLN Connects for Thursday, March 24, 2022April 2022 Update of the Hospital Outpatient Prospective Payment System (OPPS)Remittance Advice Remark Code (RARC), Claims Adjustment Reason Code (CARC), Medicare Remit Easy Print (MREP) and PC Print UpdateClaims Processing Instructions for the New Pneumococcal 15-valent Conjugate Vaccine Code 90671 and Pneumococcal 20-valent Conjugate Vaccine Code 90677MLN Connects Special Edition: Wednesday, March 30, 2022MLN Connects for Thursday, March 31, 2022MLN Connects Special Edition: Thursday, March 31, 2022MLN Connects Special Edition: Monday April 4, 2022MLN Connects Special Edition: Wednesday, April 6, 2022MLN Connects for Thursday April 7, 2022MLN Connects Special Edition: Thursday, April 8, 2022Value-Based Insurance Design Model: Medicare Advantage Organizations Pay for Hospice CareUnsolicited Voluntary RefundsHospices: Aggregate and Inpatient Caps under the Value-Based Insurance Design ModelMLN Connects Special Edition: Monday, April 11, 2022MLN Connects for Thursday, April 14, 2021MLN Connects Special Edition for Monday, April 18, 2022Top Time-Saving Tools for Palmetto GBA ProvidersUpdate to Publication 100-04, Chapter 18 and Publication 100-02, Chapter 15, Section to Add Data Regarding Novel Coronavirus (COVID-19) and its Administration to Current Claims Processing Requirements and Other General UpdatesMLN Connects for Thursday, April 21, 2022MLN Connects for Thursday, April 28, 2022Update to Chapter 7, 'Home Health Services', of the Medicare Benefit Policy Manual (Pub 100-02)Calendar Year 2023 Modifications/Improvements to Value-Based Insurance Design (VBID) Model - ImplementationIf You've Contacted Us Recently, We Would Love to Hear About Your Experience!MLN Connects for Thursday, May 5, 2022Revisions to Medicare Part B Coverage of Pneumococcal Vaccinations for the Medicare Benefit Policy Manual Chapter 15, Section 50.4.4.2eTicket Enables Providers to Save Time with Every CallMLN Connects for Thursday, May 12, 2022ePass is Available to Ease the Burden of Repeated Authentication When Calling Palmetto GBA's Provider Contact Center

Last Updated: 04/01/2016