CMS announced that, effective January 1, 2024, suppliers will be able to bill CGM supplies in 90 day increments.
According to change request CR13397, the purpose of this Change Request (CR) is to instruct Medicare
Administrative Contractors (MACs) to make adjustments to their local edits to allow for CGM supplies to be billed in 90 day increments to align with the current practices in place for Blood Glucose Monitor (BGM) supplies.
Edits that effect the Fraud Prevention System (FPS) and Unified Program Integrity Contractor (UPIC) will also be adjusted to 90 day increments accordingly. The timing of the adjustments to all three edits shall be consistent.
This will become effective on January 1, 2024.
Do you currently provide CGM devices and supplies to your patients or are you considering adding on this product category?
The van Halem Group team is here to help you! Let our team of experts provide you with education and training to ensure you understand coverage and documentation requirements. We also provide clinical prescreen review services of your claims prior to billing! Our expert clinical staff will review the documentation to determine all requirements have been met prior to dispensing the products to assure compliance with all requirements. This reduces unnecessary risk of claim denials or overpayments. Our reviews can also be used as educational tools with referral sources and transfers some of the burden of being a “difficult provider” to us.
Our Clinical Prescreens are per file fees and based upon complexity.
Want to know more? Contact us today!