Centers for Medicare & Medicaid Services (CMS)

Mar 11

Written By Christine Hall

Behavioral Health Integration Services - https://www.cms.gov/files/document/mln909432-behavioral-health-integration-services.pdf

Centers for Medicare & Medicaid Services (CMS) - https://www.cms.gov/

Frequently Asked Questions about Billing Medicare for Behavioral Health Integration (BHI) Services - https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeeSched/Downloads/Behavioral-Health-Integration-FAQs.pdf

How to Use the Medicare National Correct Coding Initiative (NCCI) Tools - https://www.cms.gov/Outreach-and-Education/MLN/Educational-Tools/MLN901346-How-to-use-the-Medicare-NCCI/ncci-medicare/chapter_2_using_the_ncci_tools/

ICD-10-CM Guidelines - https://www.cms.gov/files/document/fy-2024-icd-10-cm-coding-guidelines-updated-02/01/2024.pdf

Internet-Only Manuals (IOMs) - https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Internet-Only-Manuals-IOMs

100 Introduction
100-01Medicare General Information, Eligibility, and Entitlement Manual
100-02Medicare Benefit Policy Manual
100-03Medicare National Coverage Determinations (NCD) Manual
100-04Medicare Claims Processing Manual
100-05Medicare Secondary Payer Manual
100-06Medicare Financial Management Manual
100-07State Operations Manual
100-08Medicare Program Integrity Manual
100-09Medicare Contractor Beneficiary and Provider Communications Manual
100-10Quality Improvement Organization Manual
100-11Programs of All-Inclusive Care for the Elderly (PACE)Manual
100-12 State Medicaid Manual (The new manual is under development. Please continue to use the Paper-Based Manual to make your selection.)
100-13Medicaid State Children’s Health Insurance Program (Under Development)
100-15Medicaid Integrity Program (MIP)
100-16Medicare Managed Care Manual
100-17CMS/Business Partners Systems Security Manual
100-18Medicare Prescription Drug Benefit Manual
100-19Demonstrations
100-20One-Time Notification
100-21Reserved
100-22Medicare Quality Reporting Incentive programs Manual
100-23Payment Error Rate Measurement (Under Development)
100-24State Payment of Medicare Premiums
100-25Information Security Acceptable Risk Safeguards Manual

Medicare Coverage Database (MCD) - https://www.cms.gov/medicare-coverage-database/search.aspx

Medicare & Mental Health Coverage - https://www.cms.gov/files/document/mln1986542-medicare-mental-health.pdf

Medicare NCCI Policy Manual - https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-policy-manual

Medicare NCCI Procedure to Procedure (PTP) Edits - https://www.cms.gov/medicare-medicaid-coordination/national-correct-coding-initiative-ncci/ncci-medicare/medicare-ncci-procedure-procedure-ptp-edits

The Medicare Learning Network (MLN) - https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlngeninfo

Additional E/M Resources - https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/eval-mgmt-serv-guide-icn006764.pdf
Advance Beneficiary Notice of Non-coverage Tutorial - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/ABN-Tutorial/formCMSR131tutorial111915f.html
Advance Care Planning - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/AdvanceCarePlanning.pdf
Advanced Practice Nonphysician Practitioners - https://www.cms.gov/medicare/payment/fee-schedules/physician-fee-schedule/advanced-practice-nonphysician-practitioners
Beneficiaries Dually Eligible for Medicare & Medicaid - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Medicare_Beneficiaries_Dual_Eligibles_At_a_Glance.pdf
Chronic Care Management - https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/chroniccaremanagement.pdf
Checking Medicare Eligibility - https://www.cms.gov/files/document/checking-medicare-eligibility.pdf
Clinical Laboratory Fee Schedule Fact Sheet - https://www.cms.gov/files/document/mln006818-clinical-laboratory-fee-schedule.pdf
Complying with Laboratory Services Documentation Requirements - https://www.cms.gov/sites/default/files/2020-12/ProviderComplianceLabServices_Fact_Sheet_ICN909221.pdf
CLIA Program & Medicare Lab Services - https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/cliabrochure.pdf
Complying with Medicare Signature Requirements - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Signature_Requirements_Fact_Sheet_ICN905364.pdf
Complying with Outpatient Rehabilitation Therapy Documentation Requirements - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/OutptRehabTherapy-Booklet-MLN905365.pdf
Health Care Code Sets: ICD-10 - https://www.cms.gov/files/document/mln900943-health-care-code-sets-icd-10.pdf
HIPAA Basics for Providers: Privacy, Security, & Breach Notification Rules - https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/hipaaprivacyandsecurity.pdf
Items & Services Not Covered Under Medicare - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Items-and-Services-Not-Covered-Under-Medicare-Booklet-ICN906765.pdf
Medical Record Maintenance & Access Requirements - http s ://www.cms.gov/files/document/mln4840534-medical-record-maintenance-and-access-requirements.pdf
Medicare and Medicaid Basics - https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/programbasics.pdf
Medicare Billing 837P and Form CMS 1500 - https://www.cms.gov/files/document/837p-cms-1500pdf
Medicare Fraud & Abuse: Prevent, Detect, Report - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/Fraud-Abuse-MLN4649244.pdf
Medicare Parts A & B Appeals Process - https://www.cms.gov/files/document/mln006562-medicare-parts-b-appeals-process.pdf
Medicare Mental Health - https://www.cms.gov/files/document/mln1986542-medicare-mental-health.pdf
Medicare Secondary Payer: Don’t Deny Services & Bill Correctly - https://www.cms.gov/files/document/mln7748519-medicare-secondary-payer-dont-deny-services-bill-correctly.pdf
Medicare Overpayments - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/OverpaymentBrochure508-09.pdf
Medicare Provider Compliance Tips - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/medicare-provider-compliance-tips/medicare-provider-compliance-tips.html
Medicare Wellness Visits - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/preventive-services/medicare-wellness-visits.html
NPI: What You Need to Know - https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/NPI-What-You-Need-To-Know.pdf
Original Medicare vs. Medicare Advantage - https://www.cms.gov/files/document/mln8659122-original-medicare-vs-medicare-advantage.pdf
Proper Use of Modifiers 59, XE, XP, XS, and XU - https://www.cms.gov/files/document/mln1783722-proper-use-modifiers-59-xe-xp-xs-and-xu.pdf
Screening Pap Tests & Pelvic Exams - https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/screening-pappelvic-examinations.pdf
Teaching Physicians, Interns, & Residents Guidelines - https://www.cms.gov/files/document/guidelines-teaching-physicians-interns-and-residents.pdf
Telehealth Services - https://www.cms.gov/medicare/coverage/telehealth/list-services
Transitional Care Management Services - https://www.cms.gov/files/document/mln908628-transitional-care-management-services.pdf

CMS

Christine Hall

Telehealth

Medicare Administrative Contractors (MACs)