News & Analysis as of

Medicare Claims Processing Manual

CMS Updates Manual Provisions for Rural Health Clinics and Federally Qualified Health Centers

by King & Spalding on

On December 31, 2015, CMS updated Chapter 9 of the Medicare Claims Processing Manual and Chapter 13 of the Medicare Benefit Policy Manual addressing payment and certification of Rural Health Clinics (RHCs) and Federally...more

Selected CMS Guidance for Billing for Skilled Nursing Facility Services

by Baker Ober Health Law on

Skilled nursing facilities (SNFs) should take note of the updates and clarifications set forth in Medlearn Matters article 8997, issued by the CMS on March 13, 2015. Medlearn Matters article 8997 updates the chapters in the...more

Clinical Trial Number Required on Medicare Claims Effective January 1, 2014

by King & Spalding on

Effective January 1, 2014, CMS will require providers and suppliers to report an 8-digit clinical trial number on claims for items or services furnished pursuant to clinical trials that qualify for coverage as set forth in...more

Revision to CMS Manual Related to Anatomic Pathology Raises Additional Global Billing Issues

by Baker Donelson on

The Centers for Medicare & Medicaid Services (CMS) recently amended Medicare Claims Processing Manual (MCPM) provisions related to payment for anatomic pathology services to specifically address submission of such claims on a...more

Expect Increased Medicare Denials for Incarcerated Beneficiaries and Unlawful Aliens

by Baker Donelson on

The Department of Health and Human Services’ Office of Inspector General (OIG) recently published two reports finding Medicare improperly paid providers millions of dollars for incarcerated beneficiaries and unlawful aliens...more

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