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Notification of Medicare Reimbursement Policy Revisions Effective November 12, 2023 (Posted September 12, 2023)

Reimbursement PolicyRevision
Bundling Guidelines MA (PDF)Added DME Bundling section.  Medical Director Approved. Notification on 9/12/2023 for effective date 11/12/2023. (tlc)
Pricing and Adjudication Principles MA (PDF)Added bullet 16 for overlapping or duplicative services.  Medical Director approved.  Notification on 9/12/2023 for effective date 11/12/2023. (tlc) 
Supply and Equipment MA (PDF)Added CG modifier and Spinal Orthosis Procedures, PAP mask and tubing reimbursement limit, diabetic therapeutic inserts and shoes, ESRD supplies, catheter, portable oxygen and oxygen supplies and routine DME in Supplies and Billing Requirements. Body socks, diabetic shoe molds/inserts, repair or nonroutine service and ostomy irrigation added to Non-Reimbursable Supplies and Equipment. Notification on 9/12/2023 for effective date 11/12/2023. (tlc)