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Transmittals/MLN Marrters articls: CMS reminds providers about HPSA bonus payments, clarifies payment policy for autologous cellular immunotherapy treatment, and more

Medicare Update for Physician Services, February 2, 2012

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CMS reminds providers about HPSA bonus payments

CMS published a special edition MLN Matters Article that reminds physicians who furnish services to Medicare beneficiaries in areas designated as primary care geographic Health Professional Shortage Area (HPSA) as of December 31, 2011, they are eligible for a 10% bonus payment for services furnished from January 1, 2012, to December 31, 2012.

CMS clarifies payment policy for autologous cellular immunotherapy treatment

On January 6, CME rescinded and replaced two transmittals to clarify its payment for administration of PROVENGE®, delete certain business requirements relating to Common Working File frequency edits, and change specific dates.

View the national coverage determination transmittal  

View the Medicare claims processing transmittal

On January 25, CMS issued a transmittal that provides edits for the common working file (CWF) to reject and contractors to deny claims for Autologous Cellular Immunotherapy Treatment of Metastatic Prostate Cancer (PROVENGE®) therapy where more than three claims had been paid in a patient’s lifetime.

View the transmittal

CMS updates Medicare interest rate for overpayments and underpayments

On January 11, CMS issued a change request that updates the Medicare interest rate for overpayments and underpayments to 10.50%.

View the transmittal 

CMS releases MLN matters about three-day window payment policy

On January 10, CMS released an MLN matters article associated with a transmittal that was featured in the December 27, 2011 issue of Medicare Weekly Update.  

CMS corrects errors contained in the January 2012 OPPS update

On January 13, CMS rescinded Transmittal 2376, dated December 29, 2011, and replaced it with Transmittal 2386 to correct an error in the fixed-dollar threshold amount in section 17.d. The correct amount is $2,025. In section 5.c., table 5, CMS also corrected HCPCS code Q1079 to Q0179. HCPCS code Q1079 doesn’t exist. Additionally, CMS updated Section 18 to reflect section 308 of the Temporary Payroll Tax Cut Continuation Act of 2011 (TPTCCA).   

View the transmittal

CMS replaces MPFS transmittal to revise summary of the multiple procedure payment reduction 

On January 18, CMS rescinded Transmittal 2369, dated December 16, 2011, and replaced  it with Transmittal 2379 to revise the summary of the multiple procedure payment reduction and revisions to the practice expense geographic adjustment policies described in Section B of the Recurring Update Notification.  

CMS creates new edits to correct improper payments identified by recovery auditors

CMS updates chapter 15 of the PIM 

On January 20, CMS issued the first in a series of transmittals designed to update chapter 15 of the Program Integrity Manual (PIM). The vast majority of the revisions will either be editorial in nature, or incorporate existing policies directly into chapter 15.

View the transmittal

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