Superior Formulary Changes
Medical License Renewal Requires Fingerprints
A few physicians have reached out for help on this issue. POET has gathered some information. We hope it helps. If you continue to have issues, please feel free to give us a call.
The Texas Medical Board “TMB” will begin this process with licenses set to expire in February 2024.
Per TMB, Instructions were included in the email renewal notices that were sent out in December.
Below is the information POET was able to obtain:
You will need two numbers:
- The service code for all Texas Physicians. The code is 11G62J.
- The Physicians’ individual TMB issued 6- digit ID. (This number was assigned to the physician at the time they submitted their application for licensure. To locate the physicians’ number go to “LIST” (Licensure Inquiry System of Texas. Click the button below.
Next the physician will need to schedule with IdentoGo to be electronically fingerprinted.
The locations for our area are:
Lufkin–1012 E. Denman Avenue
Jasper–839 S. Wheeler St
Porter—24420 FM 1314 Road (closest for Livingston docs)
Once you are on the IdentoGo site:
- Click Schedule or Manage Appointment.
- Complete all the required fields
- Enter the physicians TMB issued 6- digit number with “MB” in front (Example MB-123456).
- Click Next
- Complete all the required fields on the remaining pages, including choosing a location, date, and time for the appointment.
- Click Submit.
When the physician goes to their IdentoGo appointment they must provide identification.
One of the following is acceptable:
- Driver’s License issued by the State of Texas,
- State ID card issued by the State of Texas,
- Passport Book or Card,
- Permanent Resident Card.
If the physician prefers to schedule by telephone the number is (888) 467-2080.
Please have the Service Code 11G62J available when you make that call.
Putting Patient Care Before Paperwork
- Do you spend two hours completing documentation and EHR management for every one hour of treating patients?
- Do you feel Administrative work is causing increased burnout?
- Are you completing EHR work at home?
- Are you looking to take steps to reduce the myriad of bureaucratic burdens?
Help Identifying BCBS cards
The following Network IDs only apply to cards that show the TDI indicator.
This shows the plan is fully funded and regulated by TDI (Texas Department of Insuarnce).
- Blue Choice PPOSM= BCA.
- Blue EssentialsSM = HMO.
- Blue Advantage HMOSM = BAV.
- Blue PremierSM = HMH.
- MyBlue HealthSM = BFT.
- Blue High Performance (BlueHPN) = HPN
Example of Blue EssentialsSM
Note the red letters “HMO” and blue letters “TDI” on the card. This is what makes it a Blue Essentials Card.
However, with the ever-changing insurance landscape,
We highly encourage you to check Eligibility and Benefits.
It is advisable to retain any information you view, for your office to have the documentation you
need when a claim does not pay correctly or does not pay at all.
REMEMBER: IT HAS TO HAVE THE TDI INDICATOR
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COVID-19 CPT vaccine and immunization codes
After the 2024 CPT book was printed, the AMA deleted 64 codes and Appendix Q.
COVID-19 Vaccines
Administration
• 90480 – Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, single dose
Vaccine Product
• 91318 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 3mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use (6
months to 4 years) Pfizer
• 91319 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)(coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 10mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use (5-11
years) Pfizer
• 91320 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, 30 mcg/0.3 mL dosage, tris-sucrose formulation, forintramuscular use (12 years and older) Pfizer
• 91321 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 25 mcg/0.25mL dosage, for intramuscular use (6 months – 11 years) Moderna
• 91322 – Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, 50 mcg/0.5 mL dosage, for intramuscular use (12 years and older) Moderna
Receive More Accurate Payment for Medicare Complex Visits.
The new code will take effect Jan. 1, 2024. The 2024 Medicare Physician Fee Schedule allows physicians to list G2211 in addition to codes used in-office or outpatient visits for new or established patients (i.e., 99202-99215). Physicians can also use it for telehealth visits.
Texas Medical Association continues to push for additional guidance as confusion over the code’s use persists.
Medicare Physician Fee Schedule: New CPT Codes for RSV Vaccine Administration
Please Read Carefully
If your patient doesn’t have Medicare Part D, Medicare will pay for vaccine administration.
but not the vaccine under Part B.
CMS retroactively added 2 new CPT codes for respiratory syncytial virus (RSV) vaccine administration to the Medicare Physician Fee Schedule effective for dates of service on and after October 6, 2023:
- 96380 – Short descriptor: Admn rsv monoc antb im cnsl
- 96381 – Short descriptor: Admn rsv monoc antb im njx
Your Medicare Administrative Contractor will adjust claims you bring to their attention.
UHC December Monthly Overview
CMS Extends Telehealth Flexibilities to Protect Physician Privacy.
Following staunch advocacy by the Texas Medical Association, the Centers for Medicare & Medicaid Services (CMS) will not require physicians to list their home address as a practice location on Medicare enrollment forms for another year when providing telehealth services, safeguarding their privacy and safety.
During the COVID-19 pandemic, CMS allowed physicians to offer telehealth services from their homes without reporting their home address on their Medicare enrollment. However, that flexibility was set to expire Dec. 31.
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