When is a “New Patient” Considered “NEW”?
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When is a “New Patient” Considered “NEW”?

Define a "New Patient" visit?

In 2012, the American Medical Association (AMA) revised its definition of a “New Patient” in its Current Procedural Terminology (CPT®) book. However, CPT®’s definition of a new patient did not mean Medicare would necessarily follow suit. Indeed, this change did not have any impact on Medicare Part B claims. CPT® defines a new patient as: Read more

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CMS Temporarily Delays Implementation of Ordering and Referring Denial Edits

Centers for Medicare and Medicaid Services - CMS

Due to technical issues, the Centers for Medicare and Medicaid Services (CMS) has temporarily delayed implementation the ordering and referring denial edits originally planned for May 1, 2013. A new implementation date has not yet been announced. Despite the delay, we urge physicians who refer or order services for Medicare beneficiaries to enroll with Medicare Read more

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Palmetto GBA’s Appeal Denied Again, Noridian Will Be The New Contractor!

Breaking News

The U.S. Court of Federal Claims has denied two protests that were filed challenging a decision by the Centers for Medicare and Medicaid Services (CMS) to award the Medicare Administrative Contractor (MAC) contract for Medicare Parts A and B in Jurisdiction E to Noridian Administrative Services. CMS and Noridian will now move forward to implement Read more

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Single Health Plan for 456,000 Californians Coming Soon

CalDuals - Medicare and MediCaid

Beginning October 2013, Californians who are eligible for both Medicare and Medicaid (Medi-Medi) will have to sign up with one single health plan. This is as a result of a signed Duals Demonstration Memorandum of Understanding (MOU) on March 27, 2013 between California’s Department of Health Care Services (DHCS) and the federal Centers for Medicare and Medicaid Services (CMS). This Read more

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Avoid the e-Prescribing Penalty for 2013

Medicare E-Prescription Payment Adjustment 2013-2014

The deadline for Medicare e-Prescription (eRx) is June 30th, 2012. As a Medicare provider, you may be subject to 1.5% Medicare penalty if you do not send 10 electronic prescriptions and report 10 corresponding G-codes. Physicians who are subject to a penalty are also required to adjust co-insurance or co-pay amounts. Medicare e-Rx Incentive Program is Read more

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