Monday September 16th 2019

ANA offers guidance on new Medicare billing codes

The American Nurses Association (ANA) is providing educational resources to help RNs and advanced practice registered nurses (APRNs) learn how to incorporate new Medicare payment policies for core nursing services into their practices.

The new Medicare payment policies for “transitional care management” and “complex care coordination” services went into effect Jan. 1. Under the Medicare Physician Fee Schedule Final Rule, Medicare will reimburse for transitional care management services in the first month after high-need patients are discharged from the hospital. Nurse practitioners, clinical nurse specialists and certified nurse-midwives (as well as physicians and physician assistants) are eligible to bill for transitional care management services.

Additionally, the Medicare rule recognizes new billing codes for complex chronic care coordination, which includes care coordination activities typically provided by RNs or APRNs. However, the Centers for Medicare and Medicaid Services currently will not separately pay for complex care coordination services.

To assist its members, ANA has compiled Frequently Asked Questions that explain the new codes, which are posted on ANA’s web page on care coordination at www.nursingworld.org/care-coordination. An educational webinar is being presented on Feb. 20.

Mental health code resources

With the changes, Medicare adopted major new coding and reimbursement policies for psychiatric and mental health services. The new psychiatric codes apply to psychiatric/mental APRNs and other mental health providers.

ANA collaborated with its organizational affiliate, the American Psychiatric Nurses Association (APNA), to develop educational webinars about the new psychiatric codes and reimbursement. The webinars are available on APNA’s website at http://elearning.apna.org/cpt.php, free to members and nonmembers.

ANA resources

To learn more about Medicare billing codes and care coordination, visit ANA’s Web page on care coordination at www.nursingworld.org/care-coordination.

Sign up for the 2013 Psychiatric Service Codes webinars at http://elearning.apna.org/cpt.php.

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