Medicare Part B Billing and Clinical Updates

MACtoberfest?

Medicare Part B Billing and Clinical Updates

Presented by: Shannon Chase Senior Provider Relations Representative Charles Canaan Senior Provider Education Consultant Provider Outreach and Education

Pre-Test

Welcome! I'm Paul Metto! What do you know?

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Agenda

? Updates and Changes ? CERT Overview ? Hot Topics and Reminders ? CERT Top Denials ? Medical Review Top Denials ? Comparative Billing Reports (CBRs)

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Updates and Changes

MACRA Education

? Provided by CMS ? CMS MACRA web page

? Quality Payment Program (QPP) education:



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Medicare Diabetes Prevention Program (MDPP) Expanded Model

? Allows Medicare beneficiaries to access evidence-based diabetes prevention services

? Aims to reach the goal of a lower rate of progression to type 2 diabetes, improved health, and reduced spending

? Is an expansion of the Diabetes Prevention Program (DPP) model test

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Medicare Diabetes Prevention Program (MDPP) Expanded Model

Coverage: ? Structured coaching sessions ? Performance based payment ? G-Codes ? No referral required ? Providers must enroll as MDPP supplier

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