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Are You Aware of the New Caregiver Training Service (CTS) Codes?

In healthcare, the role of caregivers is important in supporting patients’ functional performance in their homes or communities. For traditional Medicare Part B, beginning Fiscal Year (FY) 2024, the Centers for Medicare and Medicaid Services (CMS) adopted Current Procedural Terminology (CPT) codes for Caregiver Training Services (CTS). CPT codes 97550, 97551, and 97552 are reimbursable by Medicare when a physician or a non-physician practitioner (NPP) (nurse practitioners, clinical nurse specialists, certified nurse-midwives, physician assistants, and…

SNF Consolidated Billing Reminder for 2024: Are You Following the Requirements for Consolidated Billing?

The term consolidated billing includes services and/or equipment and supplies that are provided to a resident who is in a Skilled Nursing Facility (SNF) and being billed under Medicare Part A. The regulations outline who is responsible for paying for the services while under Medicare Part A. The consolidated billing rules eliminate the potential for duplicate billing for the same service and also allows the SNF to oversee and coordinate the total package of care…

Is Your SNF Involved in the “SPE” Yet?

As you should be aware, the Centers for Medicare and Medicaid put out a statement in Transmittal 12037 regarding the intention to have the Medicare Administrative Contractors (MACs) perform a five (5) claim probe and educate medical review on every Skilled Nursing Facility (SNF) in their jurisdiction. The purpose of this widespread review is to lower the SNF improper payment rate. This transmittal was published May 15, 2023. The reason for the audit was because…