Medicare Update from ACA
According to the 2024 Medicare Physician Payment Schedule (MPFS), chiropractors are experiencing a 5.37 MPFS percent cut this year.
According to the 2024 Medicare Physician Payment Schedule (MPFS), chiropractors are experiencing a 5.37 MPFS percent cut this year.
In mid-Summer 2021, the NYSCA issued a memorandum in response to a question about whether chiropractors as merchants could levy a surcharge on a patient who used her credit card to pay for her deductible, copayment or visit charge in order to offset the credit card companies processing fees often referred to as “swipe fees.”
On Wednesday, November 29, 2024 NGS Medicare released a statement that the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS) is now available. You can view the new fees using the Fee Schedule Lookup tool located on NGSMedicare.com.
On October 12, 2023, the Centers for Medicare & Medicaid Services (CMS) released the 2024 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2024 Medicare Part D income-related monthly adjustment amounts.
Enrollee benefits have changed for certain groups in The Empire Plan effective July 1, 2023. We have included information relative to massage therapy and acupuncture, for those NYSCA members who provide these services in their office. Please note: The New York State Health Insurance Program (NYSHIP) Empire Plan for NY state and local government employees is not Empire Blue Cross Blue Shield.
The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The use of the renewed form with the expiration date of 01/31/2026 will be mandatory on 6/30/23. You may continue to use the ABN form with the expiration date of 6/30/23 until the renewed form (expiration date 01/31/2026) becomes mandatory on 6/30/23. The ABN form and instructions may be found below in the downloads section.
Arlington, Va. – Both the U.S. House of Representatives and the U.S. Senate have reintroduced legislation to increase access to Medicare-covered services provided by doctors of chiropractic. The Chiropractic Medicare Coverage Modernization Act (H.R. 1610/ S. 799) would bring Medicare’s coverage of chiropractic into alignment with most other federal programs and private health plans, giving seniors improved coverage of non-drug treatments to alleviate pain and improve function.
2023 brings forth continued positive changes for doctors of chiropractic practicing in New York. Across the state certain health plans have increased fee schedules and enhanced coverage. In addition, a few third-party administrators have been eliminated, and unreasonable utilization review has been discontinued. Reasonable reimbursement and the elimination of administrative burdens affords us more time to assist our patients in achieving their goals. With significant involvement from our members, the NYSCA continues our drive to parity and fairness in reimbursement and administrative practices.
For those of you who got an early start, please go back and check the fees again as the revised fee schedule has just been posted. Please make sure you are using the most up to date fee schedule when sending your claims to Medicare or billing your patient prior to submitting claims if you are non-participating.
NYSCA members have asked for updates on the Medicare fee schedule. As of now, there are no changes and no changes are anticipated until the House leadership is sorted out.
The U.S. Senate has introduced a bill, S. 4042, to modernize Medicare coverage and better meet the needs of today’s seniors by increasing access to services provided by doctors of chiropractic. An identical bipartisan-supported bill in the House currently has 130 cosponsors.
Every year there are updates to the ICD-10 codes. These codes take effect 10/1/2021. This year's coding updates that will affect chiropractic claims are listed below:
ACA has been part of two coalitions fighting these cuts and is supporting legislation designed to place a one-year moratorium on the planned cuts, to allow congress to develop a long-term solution. Contact your federal representative here and urge them to cosponsor this legislation, H.R. 8505.
A NYSCA member asks: A patient just called to make an appointment; however, they attended a protest a few days ago. Can I see them if they have not demonstrated Covid-19 symptoms?
The NYSCA is pleased to share with you the following educational opportunity from National Government Services. This platform will allow you to hear about the latest Medicare education from the NGS Provider Outreach and Education team and ask your questions immediately following.
In order to increase cash flow to providers of services and suppliers impacted by the 2019 Novel Coronavirus (COVID-19) pandemic, the Centers for Medicare & Medicaid Services (CMS) has expanded our current Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers. The expansion of this program is only for the duration of the public health emergency. Details on the eligibility, and the request process are outlined below. The information below reflects the passage of the CARES Act (P.L. 116-136).
Some good news for doctors amidst the Corona Virus crisis: Some doctors may already be seeing this money in their account; you may be seeing it in your account soon.
During the COVID-19 crisis, telemedicine and telehealth services will allow you to continue to care for your patients from a distance. The NYSCA Insurance Committee continues to interact with various NYS offices, commercial carriers and TPAs to discuss and seek their guidelines relative to the application and coverage of telemedicine services for doctors of chiropractic.
UnitedHealthcare will require the use of a 'GP' modifier for all billed physical medicine services effective 04/01/2020.
In response to the CMS call for Feedback on Scope of Practice, the NYSCA has submitted the following: