CMS offers Medicare coding, payment guide

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Medicare beneficiaries and their healthcare providers now have a guide to Medicare coverage, coding and payment for new technologies under the Medicare fee-for-service program.

Issued by the Centers for Medicare & Medicaid Services (CMS), The Innovator’s Guide to Navigating CMS provides a roadmap for technology developers to make their products available to Medicare beneficiaries. This is the first time it has been presented in a single resource document, according to CMS.

In some cases, the agency said that Medicare may need to make explicit coverage, coding or payment changes to ensure the coverage of reasonable and necessary new treatment options and the availability of medically appropriate technologies to its beneficiaries.

The guide was developed by the CMS Council for Technology and Innovation (CTI), a CMS-wide working group composed of senior CMS staff and clinicians that was established by the Medicare Prescription Drug, Improvement and Modernization Act of 2003. The guide can be downloaded via the CTI web page.