Medicare Coverage Database – Centers for Medicare & Medicaid Services

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01/12/2017: CMS has determined that the Medicare Administrative Contractors (MACs) in Jurisdictions 5, 6, 8 and 15 will not be further consolidated. It is anticipated that for these four (4) jurisdictions, their LCDs and Articles details pages will be updated in late April 2017 to reflect their numbered jurisdiction. The display on the document detail pages will be changed from “N/A” to the specific jurisdiction number  in the Jurisdiction Column.  Currently, other MAC jurisdictions have their lettered jurisdiction displayed in this field.
Source: cms.gov

Skilled nursing facility (SNF) care

Your doctor may order observation services to help decide whether you need to be admitted to the hospital as an inpatient or can be discharged. During the time you’re getting observation services in the hospital, you’re considered an outpatient—you can’t count this time towards the 3-day inpatient hospital stay needed for Medicare to cover your SNF stay. Find out if you’re an inpatient or an outpatient.
Source: medicare.gov

Local Coverage Determinations

As a result of the Benefits Improvement and Protection Act of 2000 (BIPA 2000), all Local Medical Review Policies (LMRPs) were converted to LCDs. The difference between LCDs and previously written LMRPs is that LCDs contain only reasonable and necessary conditions of coverage as allowed under section 1862(a)(1)(A) of the Act. LMRPs may have also contained other information such as coding and payment guidelines. Coding and payment information that is not related to section 1862(a)(1)(A) is not contained in an LCD, Contractors communicate such information in related articles.
Source: cms.gov

Medicare Coverage for Air Ambulance

If Medicare doesn’t cover your ambulance trip, you have a right to appeal. An appeal is a special kind of complaint you make if you disagree with decisions made by Medicare. To file an appeal, carefully review your MSN. It will tell you why your bill wasn’t paid, how long you have to file an appeal, and what appeal steps you can take. If you decide to file an appeal, ask your doctor or provider for any information that might help your case. You should keep a copy of everything you send to Medicare as part of your appeal. If you need help filing an appeal, call 1-800-MEDICARE (1-800-633-4227) to get the number for the State Health Insurance Assistance Program in your state.
Source: usairambulance.net

Medicare Coverage of Speech

This area of the Reimbursement site provides information on the major aspects of Medicare related to audiology and speech-language pathology services, including Medicare coverage guidelines and reimbursement rates.
Source: asha.org

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