Medicare

 

Latest News

11/27/2017

ACA Submits Comments on CMS-9930-P, Patient Protection and Affordable Care Act; HHS Notice of Benefit and Payment Parameters for 2019 

11/20/2017

ACA Submits Comments in Response to a Request for Information (RFI) from CMS' Center for Medicare and Medicaid Innovation (CMMI)

11/17/2017

CMS Announces 2018 Medicare Part A and B Deductibles and Premiums.  Read CMS' Fact Sheet.

For more news, see “Updates” below.



About Medicare

Medicare is the federally sponsored fee-for-service health insurance program for people 65 years of age or older and certain younger people with disabilities. Medicare beneficiaries may choose the services of any care provider whose services are recognized by Medicare. Traditional Medicare has two Parts: Medicare Part A (hospital insurance) and Medicare Part B (general medical insurance). 

Since their 1972 inclusion in the Medicare program, doctors of chiropractic have been recognized as physicians, but only for treatment by means of manual manipulation of the spine to correct a subluxation (i.e. spinal manipulation). Under the policies developed by the Centers for Medicare and Medicaid Services (CMS), Medicare Part B coverage of chiropractic services is specifically limited to medically necessary spinal manipulation services that are considered active/corrective in nature. The manipulative services rendered must have a direct therapeutic relationship to the patient’s condition and provide reasonable expectation of recovery or improvement of function. However, when further improvement cannot reasonably be expected from continuing care, the services are considered maintenance therapy, which is not considered medically reasonable or necessary under the Medicare program, and are therefore not covered/reimbursable. Additionally, although many Medicare procedures are within their scope of practice, no other diagnostic or therapeutic service furnished by a doctor of chiropractic, or under his or her order, is considered a covered service.

The Current Procedural Terminology (CPT) codes used when reporting chiropractic manipulation services include: 
98940: Chiropractic Manipulative Treatment (CMT); spinal, one or two regions;
98941: CMT; spinal, three to four regions; and
98942: CMT; spinal, five regions.

If you are unable to find the necessary information in the resources listed below, please fill out the form located here.  ACA would also encourage you to contact your Chiropractic Carrier Advisory Committee (CCAC) member for assistance specific to your state/carrier. 

Updates

11/02/2017  -  CMS Releases Final Rule on the Medicare Physician Fee Schedule giving Medicare providers a payment increase of 0.41%.  Read CMS' Fact Sheet.

11/01/2017 -  Physician Compare Preview Period is Now Open Until Dec. 1 at 8pm ET


The Physician Compare 30-day preview period is officially open. Providers can preview their 2016 performance data as it will appear on Physician Compare later this year. You can access the secured measure preview site through the PQRS portal - Provider Quality Information Portal (PQIP).

CMS Resources:

(Note: These resources indicate that providers only have until Nov. 17 to preview their data; however, due to technical difficulties that have been resolved, CMS has extended the deadline until Dec. 1.)

To learn more about the PY 2016 performance information and PY 2015 clinician utilization data that are available for preview, download the measure crosswalks from the Physician Compare Initiative page:

10/27/2017 - ACA submits comments on

 

HHS Strategic Plan FY 2018-2022


10/25/2017 - New Medicare Cards Are Coming in April 2018

08/21/2017 -  ACA submits comments on  CMS-5522-P, Medicare Program; CY 2018 Updates to the Quality Payment Program 


06/21/2017 - 
CMS issues proposed rule to amend some existing requirements and implement new policies in the second year of the Quality Payment Program (QPP). Proposed changes are intended to increase flexibility, reduce burden, and encourage provider participation in the Merit‐Based Incentive Payment System (MIPS) or Advanced Alternative Payment Models (APMs).

10/14/2016CMS finalizes regulations implementing the Merit‐Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule. All DCs are urged to review ACA’s new Final Rule overview

06/27/2016 -  ACA submits comments on CMS–5517–P, Medicare Program; Merit-Based Incentive Payment System (MIPS) and Alternative Payment Model (APM) Incentive Under the Physician Fee Schedule, and Criteria for Physician-Focused Payment Models; Proposed Rule