If CCM billing requirements are met and the facility is not receiving payment for care management services (for example, the beneficiary is not in a Medicare Part A covered stay), practitioners may bill CPT 99490 for CCM services furnished to beneficiaries in skilled nursing facilities, nursing facilities or assisted living facilities. The place of service (POS) on the claim should be the billing location (i.e., where the billing practitioner would furnish a face-to-face office visit with the patient). Same for homebound patients.
If an IDTF furnishes any type of mammography service (screening or diagnostic), it must have a Food and Drug Administration (FDA) certification to perform such services. However, an entity that only performs diagnostic mammography services should not be enrolled as an IDTF. Screening mammographies (including those that are self-referred) are payable by Medicare when performed in and by an IDTF entity.
Medicare Part B covers screening mammogram once in 12 months (11 full months must have passed since previous screening) and diagnostic mammogram in case of medical necessity. No coinsurance and deductible applies to screening, but does to diagnostic mammogram.
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