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Coming Soon: PECOS 2.0

CMS recently announced several updates to the online Provider Enrollment Chain and Ownership System (PECOS). Beginning this summer, PECOS will unveil the...

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Recent Blog Posts

Coming Soon: PECOS 2.0

CMS recently announced several updates to the online Provider Enrollment Chain and Ownership System (PECOS). Beginning this summer, PECOS will unveil the latest version, touted by CMS to make the process of applying to “become a Medicare provider...

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Industry Veteran Kit Shellhouse Joins The van Halem Group

Atlanta, GA – Kit Shellhouse, formerly of ECS North and ACU-Serve, has joined The van Halem Group, a division of VGM Group, as the Director of Business Development. With her client-focused approach and more than 20 years of experience in the...

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Power Mobility Device (PMD) Accessory Voluntary Prior Authorization

CMS added the following PMD accessory HCPCS codes for voluntary authorization. The goal of this process is to increase operational simplicity by allowing suppliers to request prior authorization for a PMD accessory. The DME MACs will begin accepting...

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Updating your provider enrollment file? Use the current 855-S...or else!

CMS recently updated the 855-S DMEPOS supplier application, effective January 9, 2023. The new form can be found on the CMS Forms List and is currenlty being accepted for new enrollments and changes of information.  The National Provider Enrollment...

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Final Continuous Glucose Monitor (CGM) policy released

Medicare released the final draft of the new Glucose Monitor LCD and Policy Article with an effective date of 4/16/2023. The change was completed after a response to comments for the LCD. This new policy revamps the current CGM coverage criteria with...

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Biden announces end to PHE

On Monday, January 30, 2023, the Biden Administration announced that it will end COVID-19 emergency declarations on May 11, 2023. This comes on the heels of the most recent PHE extension, effective January 11, 2023, which was extended until April 11,...

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CMS adds 10 codes to F2F/WOPD list

On January 17, 2023, CMS published the annual list of items that require a face-to-face encounter and written order prior to delivery (WOPD). The published list includes 10 additional orthoses codes that will require a require a face-to-face encounter...

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CGM coding changes for 2023

Effective January 1, 2023, claims submitted to Medicare for continuous glucose monitor (CGM) receivers, supplies and accessories using codes K0553 and K0554 will be rejected. These codes are discontinued on 12/31/2022. Suppliers that provide CGM devices...

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Important Provider Enrollment Updates

Recently, the CMS made updates to the Medicare Enrollment chapter of the Program Integrity Manual. These changes are effective December 5, 2022.  Notable changes include updated provider enrollment instructions for:  Ownership disclosures Electronic...

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CMS issues guidance on post PHE audits

The CMS Center for Program Integrity (CPI) posted an FAQ this week on their Spotlight page titled “Medicare Fee-for-Service Claims Review When the Public Health Emergency Ends”. From the post... Q. At the end of the Public Health Emergency...

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