Commercial Reimbursement Policy Updates for January 1, 2024
| Reimbursement Policy | Revisions |
|---|---|
| Bundling Guidelines (PDF) | Added Medical Nutrition Therapy language to Dialysis Routine Supplies and Equipment. Medical Nutrition Therapy provider specialty language added in Reimbursement Guidelines. Medical Director approved. Effective 1/1/2024. |
| Evaluation and Management Services (PDF) | Revenue Code policy reference added to Treatment Rooms section. No change to policy intent. Effective 1/1/2024. |
| Place of Service (PDF) | Added Hyperbaric Oxygen Therapy to Reimbursement Guidelines. Medical Director approved. Effective date 1/1/2024. |
| Modifier Guidelines (PDF) | Removed criteria for “Power wheelchair(s) are not eligible for reimbursement when billed with modifier NU (new equipment) or modifier UE (used equipment)”. Effective date 1/1/2024. |
Routine policy review. Code 77301 and proton beam therapy clarified. Medical Director approved. Effective 1/1/2024. | |
| Supply and Equipment Reimbursement (PDF) | Language clarification regarding Gradient Compression Garments. Nighttime Gradient Compression Garments added. “Adult” added to clarify lifetime of Orthotics and Prosthetics. Coding section updated with new compression codes. No change to policy intent. Effective 1/1/2024. |
| Telehealth (PDF) | Added procedure code G9887. Effective 1/1/2024. |
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