Saturday, November 5, 2011

CMN Status Options of Medicare IVR

DME MAC A IVR User Guide - CMN Status Options

CMN Status - Option 3

When CMN status is selected, the IVR will request the following elements:

• National Provider Identifier (NPI)
• PTAN (10-digit supplier number)
• Last 5 digits of the Tax Identification Number (TIN)
• Beneficiary Medicare number
• Beneficiary first and last name (last name and first initial if using touch-tone)
• Beneficiary date of birth
• HCPCS code

Once the authentication elements have been verified, the IVR will supply the following, if applicable:

• Initial certification date
• Recertification date
• Revised date
• Length of need

At any time during CMN status playback the caller can give the next Medicare number if multiple CMN
status requests are needed.

At the end of CMN status playback the caller has the option of saying; “change HCPCS” to obtain
information on another HCPCS code for the same beneficiary.
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Medicare physician fee schedule - Quick overview

Medicare Part B pays for physician services based on the PFS, which lists the more than 7,400 unique
covered services and their payment rates. Physicians’ services include the following:

* Office visits;
* Surgical procedures;
* Anesthesia services; and
* A range of other diagnostic and therapeutic services.


Medicare Physician Fee Schedule Payment Rates

Payment rates for an individual service are based on
three components:
1) Relative Value Units (RVU)
2) Conversion Factor (CF)
3) Geographic Practice Cost Indices (GPCI)


Medicare Physician Fee Schedule Payment Rates Formula


The Medicare PFS payment rates formula is shown below:

[(Work RVU x Work GPCI) + (PE RVU x PE GPCI) +
(MP RVU x MP GPCI)] x CF

Medicare fee schedule download