Medicaid

Medicaid

Final Stimulus Package Includes Partial Relief from 2021 Medicare Reimbursement Cuts to Audiology

On December 21, 2020, Congress passed a new stimulus package that includes provisions to mitigate planned Medicare reimbursement cuts for a variety of providers, including audiologists. 

Academy Encourages CMS to Allow Audiologists to Use Medicare Online Assessment “G” Codes

The Academy has delivered a letter to the Centers for Medicare and Medicaid Services (CMS) urging them to issue a Correction Notice to the 2021 Physician Fee Schedule to add audiologists to the list of providers able to use online assessment “G” codes designed for practitioners who are not authorized to perform evaluation and management (“E&M”) services. 

CCHP Creates "COVID-19 Related State Actions" Resource

The Center for Connected Health Policy has created a resource which provides links to all state-related actions on telehealth that have been issued in response to the COVID-19 crisis. 

State Telehealth Resource Including Medicaid Reimbursement, Private Payer Laws, and Occupation-Specific Regulations  

The Center for Connected Health Policy has released a state telehealth resource that outlines state Medicaid reimbursement, the existence of any private payer laws, as well as any occupational licensing board specific regulations with regard to the provision of services via telehealth.  

Telehealth and Medicare/Medicaid

Medicare regulations do not currently recognize audiologists as eligible providers of telemedicine services. The Academy has long advocated to change this, and we are currently working with congressional leaders to seek inclusion of such a change in legislation moving forward to address the COVID-19 pandemic.

Photo of $100 bill on a fish hook

COMPLIANCE | CMS Spotlight on Program Integrity and Provider Enrollment in Medicare, Medicaid, and CHIP

The Centers for Medicare and Medicaid Services (CMS) recently issued a final rule that provides more authority for CMS to address fraud, waste, and abuse in federal health insurance programs including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). The new rule aims to bolster the ability of CMS to fight fraudulent or other inappropriate activity before it happens and before providers are paid. 

Topic(s): Centers for Medicare and Medicaid Services (CMS), Medicare, Medicaid, Children's Health Insurance Program (CHIP), Office of General Inspector (OIG), secretary of health and human services, Provider Enrollment, Chain, and Ownership System (PECOS)

Author(s): 

Publication Issue: Audiology Today November/December 2019

CMS Issues Proposed Payment Rules for 2020

Late Monday, July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) posted the Proposed Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (OPPS) Rules for 2020. These comprehensive rules contain proposed policy and payment changes under the Medicare program.

Illustration of a cochlear implant

CODING AND REIMBURSEMENT | Potential Pitfalls in Cochlear-Implant Billing and Reimbursement

As cochlear implant awareness increases and more individuals receive cochlear implants, the demand for related audiological services is growing across the country. To meet this need, many audiologists have begun to add, or are considering adding, cochlear implant services to their practices. 

Topic(s): Coding, Reimbursement, Practice Management, Centers for Medicare and Medicaid Services (CMS), Medicare, Medicaid, Cochlear Implants (CI)

Author(s): 

Publication Issue: Audiology Today July/August 2019

Abstract illustration of coding and reimbursement for audiology

CODING AND REIMBURSEMENT | New Medicare LCD Process—What You Need to Know

Local coverage determination (LCD) policies issued by Medicare administrative contractors (MACs) serve as the workhorse of Medicare coverage policy. About 90 percent of coverage determinations are made through LCDs. Coverage policies include a defined list of services the insurer will cover and specific exclusions. Medicare provides coverage of services that are determined to be “reasonable and necessary” for Medicare beneficiaries. If a specific item or service is not covered under an LCD, this does not mean it isn’t covered. Claims may be adjudicated on a case-by-case basis.

Topic(s): Coding, Reimbursement, Practice Management, Medicare, Medicaid, Local coverage determination (LCD), Medicare administrative contractors (MACs), Centers for Medicare and Medicaid Services (CMS)

Publication Issue: Audiology Today May/June 2019

Audiology Today Mar/Apr 2019…What’s Inside This Issue?

The editorial team and I are so happy to announce the content for this latest issue of Audiology Today. We are featuring a number of comprehensive, relevant, and interesting articles, as well as some short reads on public relations, coding and reimbursement, and audiology advocacy.

Read more