Medicare Guideline posts
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
Understanding Medicare Part D special enrollment periods
Most everyone knows that when you are about to become eligible for Medicare, you should choose a Medicare approved drug plan. What many people don’t know is that Medicare Part D enrollment is not limited to first becoming eligible for Medicare or taking advantage of the Annual Enrollment Period (AEP) that takes place each year between November 15th and December 31st.
As a Medicare beneficiary, you may be able to take advantage of a Special Enrollment Period (SEP), where you are able to change your Medicare Part D enrollment. The following list defines the SEP and details the changes that can be made.
You are eligible for both Medicare and Medicaid. Also know as being dual eligible, you are able to join, change or drop prescription drug coverage anytime.
You qualify for extra help paying for your Part D coverage. You have the right to join, change or drop prescription drug coverage anytime.
You are enrolled in a State Pharmaceutical Assistance Program. You can join a prescription drug plan once during the calendar year.
You dropped a Medicare supplement (Medigap) the first time you enrolled in a Medicare Advantage Plan. Within the first 12 months of being enrolled in the Advantage Plan, you can drop that plan, return to original Medicare and pursue Medicare Part D enrollment.
You have a severe or disabling condition and there is a Chronic Special needs Plan available for you condition. You can join a Chronic Special Needs Plan that will include Part D prescription drug coverage. You can join anytime, but have lost your ability to make additional changes until your Annual Enrollment Period.
You no longer qualify for a Chronic Special Needs plan because you no longer have the qualifying health condition. You can switch plans, but only have 3 months from losing your Chronic Special Needs Plan to do so.
Labels: Medicare part D
Top Medicare billing tips
Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee...
Billing J code examples cpt code and description J0702 - Injection, betamethasone acetate 3mg and betamethasone sodium phosphate 3mg ...
PR 1 Deductible Amount PR 2 Coinsurance Amount PR 3 Co-payment Amount OA 4 The procedure code is inconsistent with the modifier used ...
Coverage Indications, Limitations, and/or Medical Necessity This LCD describes conditions under which the coverage of nail avulsion/ex...
Procedure code and description 93224 - External electrocardiographic recording up to 48 hours by continuous rhythm recording and storage;...
Procedure code and description 95004 Percut Tests w/ Extrac Immed React # Allergy testing - Percut allergy skin tests - Percutaneous ...
Drugs & Biologicals: Maximum Allowed Units (MAUs) - Palmetto GBA Medicare cpt code and description J1040 - Injection, methylpredniso...
All Service Codes for Immunization/Vaccine 86615 (CPT) - Antibody; Bordetella 86619 (CPT) - Antibody; Borrelia (relapsing fever) 8...
Procedure code and description 93015 (cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous ele...
Procedure Code Description 70370 Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique 70...