Know your modifier KX rules to ensure payment for therapy in 2021.
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Tag Archives: Amounts
Medicare Finalizes COVID-19 Vaccine Payment Amounts
Just in time for new COVID-19 vaccine, administration, and treatment codes.
The post Medicare Finalizes COVID-19 Vaccine Payment Amounts appeared first on AAPC Knowledge Center.
Allowable amounts for primary and secondary
Hi, I am hoping somebody can help with this scenario and also provide somewhere were I can find the proper documentation to support the decision:
Patient has commercial insurance A as primary, commercial insurance B as secondary. Provider is in network with both A and B.
Insurance A shows an allowable amount of $ 65, pays $ 55, patient responsibility is $ 10.
Insurance B shows an allowable amount of $ 100, pays $ 0 (applies to deductible), patient responsibility is $ 100.
Is provider supposed to bill the patient for the $ 10 per Insurance A patient responsibility,
or $ 100-$ 55 paid by insurance A=$ 45 per Insurance B.
Any help would be appreciated – as well as where I can find the documentation regarding this.
Thank you,
Susan Wood, CPC-A, CPB
KX modifier amounts announced for CY19
Cigna allowed amounts for in and out of network PT/Chiro
We have taken a significant hit on the allowed amounts for our Out-Of-Network reimbursements from Cigna starting around 3/1/18. I was wondering if anyone who is In Network has also had their allowed amounts drop? Trying to see if it is a Cigna-wide policy or just Out of Network.
2018 Hospital Deductibles and Extended Care Services Coinsurance Amounts
The Centers for Medicare & Medicaid Services (CMS) filed a notice in the Federal Register on Nov. 17 announcing the 2018 inpatient hospital deductible and hospital and extended care services coinsurance amounts for services furnished under Medicare Part A. Effective Jan. 1, 2018, the inpatient hospital deductible will be $ 1,340; the daily coinsurance amounts will be: […]
AAPC Knowledge Center
Civil Fraud Case Settlement from Fredericksburg Hospitalist Group amounts to $4.2 Million
Along with 14 of its member shareholders, Fredericksburg Hospitalist Group has agreed to pay nearly $ 4.2 million to settle a federal False Claims Act case brought under the qui tam whistleblower provisions of the FCA.
The post Civil Fraud Case Settlement from Fredericksburg Hospitalist Group amounts to $ 4.2 Million appeared first on The Coding Network.
ASC Billed Charge Amounts
I currently work at an ambulatory surgical facility. Our current billed charge amounts are highly inflated in my opinion. How do you set your billed charge amount? A percentage of Medicare allowable? I hate billing a ridiculous amount when I know we are only getting paid a small portion of that amount. I am looking to revamp our entire fee schedule if I can convince our administrator that our fees are too high.
Thank you in advance!
Thank you in advance!
Infusion Drug Payment Amounts to Change with April Update
The 21st Century Cures Act, signed into law Dec. 13, 2016, changed the way certain Medicare Part B drugs infused through durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) items will be paid beginning in April. Curing Improper Payments Section 5004 sets payment amounts for Part B drugs infused through DMEPOS items using the Average […]
AAPC Knowledge Center