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General Requirements for Medicaid Providers in Florida

Medisys Compliance

The Medicaid program in Florida provides medical services and assistance to low-income individuals and families. To participate in the Medicaid program, healthcare providers must meet several general requirements set forth by the Agency for Health Care Administration (AHCA).

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Direct Billing by MFTs and MHCs: A Comprehensive Guide for Year 2024

Medisys Compliance

Marriage and Family Therapists (MFTs) and Mental Health Counselors (MHCs) can now directly bill Medicare for services they furnish and diagnose. Eligibility and Covered Services To directly bill Medicare, you must meet specific eligibility criteria. The next step involves enrolling as a Medicare provider.

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Billing Medicare Telehealth during COVID-19 PHE

Medisys Compliance

The federal government, state Medicaid programs, and private insurers have expanded coverage for virtual health care services. During the COVID-19 public health emergency, any health care provider who is eligible to bill Medicare can bill for telehealth services regardless of where the patient or provider is located.

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Billing Guidelines for Medicare Home Infusion Therapy (HIT)

Medisys Compliance

Under Fee-for-service (FFS) Medicare, home infusion therapy (HIT) involves the intravenous or subcutaneous administration of drugs or biologicals to an individual at home. Likewise, nursing services are necessary to train and educate the patient and caregivers on the safe administration of infusion drugs in the home.

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Understanding Modifiers for Mental Health Billing

Medisys Compliance

GT Modifier – Synchronous Telehealth Services [Medicare] The GT modifier is specifically used for Medicare claims to indicate that mental health services were provided through synchronous telehealth. This modifier helps in distinguishing services provided by LCSWs from other mental health providers.

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Understanding Mental Health Telehealth Billing

Medisys Compliance

The provider must adhere to the telehealth regulations and guidelines established by their respective state’s licensing board. Covered Services: Understanding what services are covered is fundamental.

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Revised Updates for Renal Dialysis Billing

Medisys Compliance

The Centers for Medicare & Medicaid Services (CMS) on June 21, 2022, issued a proposed rule that proposes to update payment rates and policies under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to Medicare beneficiaries on or after January 1, 2023.