Medicare Fees - General Information
The Centers for Medicare & Medicaid Services (CMS) provides fee and reimbursement information to Medicare Contractors. CMS updates these amounts on a quarterly basis or as otherwise required and issues a Change Request (CR) to alert the contractors and the provider community of any changes. WPS Medicare then publishes the notification in our Listserv messages and posts the updated fee information to our Fee and Reimbursement pages:
http://www.wpsmedicare.com/part_b/fees/fees.shtml
The CMS CR provides instructions on both the effective date and implementation date of the change. These dates may not always be the same. For example, the October update to injection pricing has an effective date of January 1, 2007 with an implementation date of October 1, 2007. This means for services provided January 1, 2007 and after, the new fee applies.
The CMS instructions do not require Medicare contractors (WPS Medicare) to retrieve history to determine if an overpayment or underpayment exists. We will only adjust claims brought to our attention. Providers must make the request for any additional payment or recovery through our redetermination process. You can find the forms and instructions on our Website:
http://www.wpsmedicare.com/part_b/business/appeals.shtml
Page Last Updated: Wednesday, 30-Dec-2009 10:45:26 CST
