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LCSW Medicare Presentation for 2010
National Government Services provides Medicare Seminar for NYSSCSW
On July 14 Kathy Dunphy and Jim Bavoso of National Government Services gave a clear and informative presentation on what we can expect from Medicare. The in-person seminar at Metrotech Center in Brooklyn was accompanied by a teleconference.
Highlights of the talk were: Clarifying the fee schedule for 90801 and 90806. (There have been four different versions this year!) Currently 90806 is $105.21 for physicians, $78.91 for social workers. 90801 is $178.88 for physicians, $134.16 for social workers. These rates are in use until November 30, 2010.
Under mental health parity, the portion of the fee paid by Medicare is 55% in 2010; it will go up stepwise to 80% in 2014.
Expect a letter in August if you have not already enrolled in the PECOS database. You will not get paid in 2011 unless you enroll. Expect that Electronic Funds Transfer will become mandatory when you do.
The future calls for increased use of Electronic Claims Submission to replace paper claims. You are encouraged to seek a billing service or use Medicare billing software.
In October 2013 the ICD-10 will become the basis of diagnoses covered by Medicare.
The requirements for documenting psychotherapy visits are on the NGS website. Providers are encouraged to create a template for recording necessary information under Medicare regulations, anticipating the possibility of an audit.
For problem solving, your first step should be to call one of these numbers:
Provider Interactive Voice Recognition (IVR) 877-869-6504
Provider Customer Service Representative (CSR) 866-837-0241
For much more detail see the attached PowerPoint presentation from the seminar.
Helen T. Hoffman LCSW, State Chair, Vendorship and Managed Care Committee [email protected]
Virginia Lehman LCSW, Medicare Liaison [email protected]
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