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:

  1. 96380 – Short descriptor: Admn rsv monoc antb im cnsl
  2. 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.

Superior: Avoid Claim Denials

BILLING: Avoid Claim Denials 

As a reminder, claims submitted with invalid or unclean data will result in denial or rejection of an entire claim. Superior has provided a list of important claim submission tips and common billing errors to help ensure your claims are processed quickly and efficiently.

Review the full list of tips to ensure your claims are not denied. Just click the link.

Cigna MA Provider Directory

Per Jim there is an issue with the Cigna MA provider directory. Some providers are not listed. The problem has been reported and is being worked on. Thank you.

UHC and FedEx Team UP

UHC November Monthly Overview

Texas Medicaid: Earn 5.5 hours of free CE 
UnitedHealthcare Community Plan of Texas and the American College of Lifestyle Medicine (ACLM) are partnering to offer 5.5 hours of free CE

Keep Your Staff Up to Date

Feel Free to Download and Print.

These lists can help your staff in so many ways.

Just Click, Download and Print

New Criminal History Background Check Requirement from TMB!

TMB to Start Fingerprinting With February License Renewals

Under a new law passed by the 2023 Texas Legislature, the Texas Medical Board (TMB) is set to roll out fingerprinting requirements for criminal history background checks as a part of physicians’ licensure renewal. TMB told TMA it is planning to start that process with February 2024 license expirations; instructions will be part of the email renewal notices that go out in December. Those licenses expiring in November are not affected for now. Texas Medicine Today will have additional coverage as more information becomes available. In the meantime, check the TMB website for updates.

Fingerprinting services are provided through IdentoGo by IDEMIA (formerly known as MorphoTrust USA, LLC) for a fee (see the Fingerprinting FAQs below for the current fees), payable directly to IdentoGo. Results of the fingerprinting will be sent directly to TMB from both the Texas Department of Public Safety Criminal Records and the Federal Bureau of Investigation.

Requirements for Claim Submissions 11/1/2023