New & updated billing policies are now available

We publish billing policies to offer transparency and help providers bill claims more accurately to reduce delays in processing claims, as well as avoid rebilling and additional requests for information.

The following billing policies were recently published to or updated in our Provider Manual. These policies reflect our current requirements / system set up – they don’t change the way you work with us or how you’re reimbursed.

Note: If a policy is listed as a revision, the changes made are detailed on the last page of the policy.

• Always / sometimes therapy – new
• Bladder scans – new
• Cardiac rehabilitation – new
• Care management services – revision
• Compression garments – new
• Critical access hospital (CAH) method II billing – new
• Durable medical equipment (DME) / prosthetic & orthotics modifiers – revision
• Endomyocardial biopsy with right heart catheterization – new
• Enteral nutrition – new
• Evaluation & management – revision
• Home health – new
• Lab & pathology – revision
• Maternity and prenatal care – new
• Medicare Annual Wellness Visit (AWV) and preventive care visits – new
• Negative pressure wound therapy pumps – new
• Skilled nursing facility – new
• Split / shared billing – revision
• Unlisted codes – new