Payment policy
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Updates
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Allergy Services
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- Annual review
- Updated related policies section
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Assisted Reproductive Technology
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- Annual review
- Added CPT & HCPCS Modifiers policy as reference
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Chiropractic
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- Annual review; no updates
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COVID-19 Public Health Emergency temporary payment policy
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- Added vaccine and vaccine administration codes: 0073A, 91305, 0051A, 0052A, 0053A, 0054A
- Added monoclonal antibody codes: Q0220, M0220, and M0221
- Clarified that the telehealth reimbursement section is effective until 3/31/22, and that effective 4/1/22 the telehealth guidelines within this document will be replaced by the following updated payment policies: Telehealth – Mental Health and Telehealth – Medical Services
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Diabetic Care
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- Annual review
- Inclusion of A4224 information
- Updated information on A9274
- Removed billing guidelines for V-Go insulin delivery system
- Updated title for certified diabetes educator
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Durable Medical Equipment
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- Annual review
- Updated breast pump and supply information
- Addition of ostomy supplies information
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Gastroenterology
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- Annual review
- Removed reference to effective date
- Updated information regarding E/M reimbursement with 0, 10, or 90-day global procedures
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Non-Reimbursable Services
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- Updated non-reimbursable list for professional providers link and non-reimbursable list for facility providers link
- M1072-M1089 and M1094-M1105 code ranges were removed from professional and facility non-reimbursable list
- Added Q0220, Q0221, and Q0222 to non-reimbursable list and end-dated G1009 and M1145
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Podiatry
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- Annual review; no updates
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Radiology
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Radiology- Multiple Imaging
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- Annual review
- Edits for reimbursement clarity
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Respiratory DME
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- Annual review
- Edited to clarify for TW modifier
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Surgery – Professional
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- Annual review
- Added reimbursement information regarding surgeries within the global period of another surgery
- Addition of teaching physician criteria
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Telehealth – Medical Services
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- Edited for clarity in the Reimbursement section
- Edited for clarity in the Professional Non-Facility (office) Reimbursement versus Professional Facility Reimbursement section
- Addition of place of service billing scenarios
- Removal of examples of HIPAA-compliant technology
- Edited for clarity on provider licensing requirements
- Edited for clarity on Medicare Advantage statement
- Added link to CMS list of chronic condition categories
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Telehealth – Mental Health
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- Edited for clarity in the Reimbursement section
- Edited for clarity in the Professional Non-Facility (office) Reimbursement versus Professional Facility Reimbursement section
- Addition of place of service billing scenarios
- Removal of examples of HIPAA-compliant technology
- Edited for clarity on provider licensing requirements
- Edited for clarity on Medicare Advantage statement
- Updated list of face-to-face mental health services eligible to be performed via telehealth and/or telephone
- Updated list of reimbursable telephonic and telehealth services to include: H0025, H0046, 99439, G1028, 99424, 99425, 99426, 99427, and 99437
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