FAQ-Medicare Fee Schedule

Medicare Fee Schedule FAQs Q: Where can I find my Medicare Fee Schedule? A: You can find the Medicare Fee Schedule on your Medicare Administrative Contractor’s (MACs) website. Many of the MACs offer a link on their home page that directs you to the fee schedule look-up tool. You need to know your enrollment status...
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Additional Rules Options -Excluded Services

Additional Rules and Options for Statutorily Excluded Services The only services covered under Medicare when ordered or delivered by a chiropractor are the three spinal adjustment codes (98940, 98941, 98942). These codes are only covered when Medical Necessity is met; otherwise, the patient is considered in the maintenance phase of care. When a patient transitions...
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The Voluntary Advance Notice ABN Form

When providers use the official ABN form for advance notice about excluded services, other considerations apply. This is the reason we at KMC University encourage providers to use another form to provide advance notice for the services Medicare never covers. Do not confuse this with the responsibility associated with mandatory use of the ABN, covered...
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Excluded Service Modifiers Can Make or Break Your Claims

Now that you’ve learned about the difference between modifiers for spinal CMT codes, and those for excluded services, let’s dig a bit more into two critical excluded service modifiers. The GP and GY modifiers may seem unimportant because they are appended to codes that are not covered by Medicare. But misuse or omission of either...
Oops, your level of membership doesn’t include access to these advanced materials. They are reserved for members working 1-on-1 with our specialists for analysis and training. Please reach out to the HelpDesk to learn more about accessing these materials. Click here to learn more.