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Medicare Compliance & Reimbursement

CME MANUAL UPDATE

Published on Thu Dec 11, 2003

Providers of ambulance services can gain a bit of insight into how carriers calculate the reasonable charge portion of their blended transitional payments from a Nov. 21 one-time notification (change request 2700) from the Centers for Medicare & Medicaid Services. For new suppliers, the reasonable charge should be the lower of: the supplier's submitted charge, the 50th percentile prevailing charge, and the prevailing inflation-indexed charge, CMS explains.

            In other recent one-time notifications, CMS:

           

  • updates remittance advice remark codes and claim adjustment reason codes (CR 2975);

               

  • announces the next quarterly update to the Correct Coding Initiative edits (CR 2938); and

               

  • clarifies previous contractor guidance relating to the Medicare single drug pricer (CR 2950).

    To see the transmittals, go to http://cms.hhs.gov/manuals/transmittals/comm_date_dsc.asp.

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