Palmetto GBA E-mail Update: Tuesday, September 13, 2016

2016-2017 Influenza (Flu) Resources for Health Care Professionals
Keep this Special Edition MLN Matters article and refer to it throughout the 2016 – 2017 flu season. Take advantage of each office visit as an opportunity to encourage your patients to protect themselves from the flu and serious complications by getting a flu shot. Continue to provide the flu shot as long as you have vaccine available, even after the new year. Remember to immunize yourself and your staff.

Applies to:

  • JM Part A//General
  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

2017 Annual Update for the Health Professional Shortage Area (HPSA) Bonus Payments
Change Request (CR) 9781 alerts you that the annual HPSA bonus payment file for 2017 will be made available by the Centers for Medicare & Medicaid Services (CMS) to your MAC and will be used for HPSA bonus payments on applicable claims with dates of service on or after January 1, 2017, through December 31, 2017. Check the Physician Bonuses webpage each year to determine whether you need to add modifier AQ to your claim in order to receive the bonus payment, or to see if the ZIP code in which you rendered services will automatically receive the HPSA bonus payment. Make sure that your billing staffs are aware of these changes.

Applies to:

  • JM Part A//General
  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

Ambulance Staffing Requirements
Change Request (CR) 9761, manualizes the Calendar Year (CY) 2016 revisions to the ambulance staffing requirements and provides clarifications on the definitions for ground ambulance services for Advanced Life Support, Level 1 (ALS1), ALS assessment, application for ALS, Level 2 (ALS2), Specialty Care Transport (SC T), Paramedic Intercept (PI), emergency response, and inter-facility transportation. Please make sure your billing staff is aware of these revisions.

Applies to:

  • JM Part A//General
  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

Influenza Vaccine Payment Allowances – Annual Update for 2016-2017 Season
Change Request (CR) 9758 informs MACs about the payment allowances for seasonal influenza virus vaccines. These payment allowances are updated on August 1 of each year. The Centers for Medicare & Medicaid Services (CMS) will post the payment allowances for influenza vaccines that are approved after the release of CR9758 . Make sure that your billing staffs are aware that the payment allowances are being updated.

Applies to:

  • JM Part A//General
  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

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