Medicare Transmittals & MLN Articles
June 1, 2023: MLN MM13055: Audiologists May Provide Certain Diagnostic Tests Without a Physician Order
Effective July 1, 2023, one visit to an audiologist without a physician or NPP order is permitted, per patient, once every 12 months. This change was finalized in the CY 2023 Physician Fee Schedule (PFS) rulemaking. https://www.cms.gov/files/document/mm13055-audiologists-may-provide-certain-diagnostic-tests-without-physician-order.pdf
June 2, 2023: MLN MM13056: New JZ Claims Modifier for Certain Medicare Part B Drugs
CMS advises that your billing staff know about using JW modifier data to show discarded amounts of drugs in a single-dose container or single-use package and reporting requirements for the new JZ modifier starting July 1, 2023. https://www.cms.gov/files/document/mm13056-new-jz-claims-modifier-certain-medicare-part-b-drugs.pdf
June 5, 2023: MLN MM13235: DMEPOS Fee Schedule: July 2023 Quarterly Update
Make sure your billing staff knows about the fee schedule adjustment relief for rural and non-contiguous areas and supplier education on power wheelchair repair. https://www.cms.gov/files/document/mm13235-dmepos-fee-schedule-july-2023-quarterly-update.pdf
June 7, 2023: MLN MM13164: Skilled Nursing Facility Probe and Educate Review
Medicare Administrative Contractors (MACs) will be reviewing a small sample of five SNF claims for each SNF in their jurisdiction. This strategy is in response to the CERT identifying SNF services as a top driver of the overall Medicare Fee-for-Service improper payment rate. CMS notes a contributing factor may be the change from the Resource Utilization Group (RUG) IV to the Patient Driven Payment Model (PDPM) for claims with dates of service on or after October 1, 2019. https://www.cms.gov/files/document/mm13164-skilled-nursing-facility-probe-and-educate-review.pdf
June 13, 2023: MLN MM13210: Hospital Outpatient Prospective Payment System: July 2023 Update
CMS advised providers to make sure billing staff knows about payment system updates and new codes for COVID-19, drugs, biologicals, radiopharmaceuticals, devices, and other items and services. https://www.cms.gov/files/document/mm13210-hospital-outpatient-prospective-payment-system-july-2023-update.pdf
June 15, 2023: MLN MM13235: New Waived Tests
This MLN highlights new waived tests effective October 1, 2023. https://www.cms.gov/files/document/mm13253-new-waived-tests.pdf
June 22, 2023: MLN MM13216: Ambulatory Surgical Center Payment System: July 2023 Update – Revised
This MLN article was initially released on May 25, 2023. With the June 22nd iteration of this article, CMS added information about a corrected payment for CPT 0697T to agree with a revised CR 13216. https://www.cms.gov/files/document/mm13216-ambulatory-surgical-center-payment-system-july-2023-update.pdf
