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Feds Propose to Expand Birth Control Coverage

New rules would amend an Affordable Care Act provision to allow more women to obtain contraceptive services at no cost. The Department of Health and Human Services (HHS) and the Departments of Labor and the Treasury (Departments) released new rules Jan. 31 that would amend the Affordable Care Act (ACA) regarding coverage of certain contraceptive […]

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AAPC Knowledge Center

Medicare Expands Cochlear Implantation Coverage

Broader coverage comes as great news for those with profound hearing loss. Cochlear implants were first covered for adult Medicare beneficiaries in October 1986 with coverage for children following in 1992. Since then, devices have been improved and there have been gradual changes in the degree of hearing loss for which the Food and Drug […]

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AAPC Knowledge Center

CMS Proposes to Extend Medicare Coverage of Immunosuppressive Drugs for Kidney Transplant Recipients

Coverage would continue after 36 months. On April 22, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule under the Consolidated Appropriations Act, 2021 (CAA) that would, in part, extend Medicare coverage of immunosuppressive drugs for kidney transplant recipients. Section 402 of the CAA proposes to extend immunosuppressive drug coverage under […]

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AAPC Knowledge Center

LDCT Coverage Expanded to Enable Earlier Detection of Lung Cancer

Medicare now covers screening for pulmonary malignancy with LDCT starting at age 50. After reconsideration of eligibility criteria, the Centers for Medicare & Medicaid Services (CMS) announced on Feb. 10 a national coverage determination (NCD) that expands coverage for lung cancer screening with low dose computed tomography (LDCT) for Medicare patients. This move is in […]

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AAPC Knowledge Center

Coverage of Non-Prescription COVID Tests

BCBS and other payers weigh in on at-home testing. In the recent article FDA Authorizes Non-Prescription COVID Tests, AAPC reported that the U.S. Food and Drug Administration (FDA) has granted emergency use authorization for at-home, over-the-counter (OTC) COVID-19 tests. On March 5, 2021, Cue Health received emergency use authorization (EUA) from the FDA for their […]

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AAPC Knowledge Center

Payers Ending Telehealth Expansion Coverage

Unless ordered otherwise, most commercial payers will return to business as usual Jan. 1, or sooner. The COVID-19 public health emergency (PHE) continues, but will expanded telehealth coverage and cost sharing waivers? Some health insurers will stop paying for expanded telehealth services as soon as Oct. 1. Patient cost-sharing may resume soon, as well. In […]

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AAPC Knowledge Center

Telehealth Coverage for Mental Health Services During COVID-19

As the global pandemic enters its fifth month, we are all feeling the strain. Staying home to slow the spread of the coronavirus may be keeping more people physically healthy, but isolation exacts a toll on mental health.

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AAPC Knowledge Center

Telehealth Coverage Expanded for Home Health, Hospice

HHAs, hospices need direct telehealth reimbursement, industry reps maintain. Medicare is giving home health agencies and hospices freer rein with telehealth visits, but providers must make sure the plan of care reflects that new usage. Telehealth for Home Health The Centers for Medicare & Medicaid Services’ Home Health Prospective Payment System final rule for calendar […]

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AAPC Knowledge Center

Feds Extend Medicare Coverage During COVID-19 Pandemic

An unprecedented “relaxation” in regulatory guidelines will give U.S. hospitals and non-traditional care sites a fighting chance to meet the high demand of COVID-19 hospitalizations expected in the coming weeks. The Trump administration issued, March 30, regulatory waivers and guidelines in the form of an interim final rule, to be implemented immediately. Loosening Criteria for […]

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AAPC Knowledge Center