CMS & Palmetto/J1MAC News

The following information has been received by ANCO.


****CMS NEWS****
On March 2, 2010, President Obama signed into law the “Temporary Extension Act of 2010.” Among other things, this law extends through March 31, 2010, the zero percent update to the Medicare Physician Fee Schedule that was in effect for claims with dates of service January 1, 2010, through February 28, 2010. Consequently, effective immediately, claims with dates of service March 1 and later which were being held by Medicare contractors will be released for processing and payment. Please keep in mind that the statutory payment floors still apply and, therefore, clean electronic claims cannot be paid before 14 calendar days after the date they are received by Medicare contractors (29 calendar days for clean paper claims).

In addition, the new law extends through March 31, 2010, the exception process for therapy clåaims reaching the annual cap, retroactive to January 1, 2010. Affected providers may submit claims for exceptions to the annual therapy caps, with dates of service January 1 through March 31, 2010, using the KX modifier, following the pre-January 1, 2010, requirements for therapy cap exceptions.

Please watch your listserv and contractor’s website for more information about the new legislation.


The MLN Matters Special Edition Article #SE1010 entitled, "Questions and Answers on Reporting Physician Consultation Services," has just been released and is available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE1010.pdf on the CMS website. This article is intended for physicians and non-physician practitioners (NPPs) who perform initial evaluation and management (E/M) services previously reported by Current Procedural Terminology (CPT) consultation codes for Medicare beneficiaries and submit claims to Medicare Carriers and/or Medicare Administrative Contractors (MACs) for those services. The article pertains to change request (CR) 6740, which alerts providers that effective January 1, 2010, the CPT consultation codes (ranges 99241-99245 and 99251-99255) are no longer recognized for Medicare Part B payment.


Consequently, MLN Matters Article #MM6740 entitled, "Revisions to Consultation Services Payment Policy," is being revised to clarify language contained in the original CR and to add a reference to MLN Matters Article #SE1010. All other information remains the same. The revised article is available at http://www.cms.hhs.gov/MLNMattersArticles/downloads/MM6740.pdf on the CMS website.


****PALMETTO J1/MAC NEWS****
J1 Provider Outreach and Education Event Calendar
Effective March 1, 2010, Palmetto GBA will switch from Saba Centra 7® to a
new Internet event host, WebEx, for all Web-based training events to offer
our providers a more user-friendly online learning experience. Check out
our March Events calendar in the next few weeks for more detailed event
announcements and technical requirements for attending WebEx events.
http://www.palmettogba.com/palmetto/providers.nsf/vMasterDID/7TAL2C7131?opendocument


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