Changes in Maryland Medical Billing for Medicare

If you are a physician located in Maryland, be aware that as of April, Medicare is now approving a broader coverage for the use of home oxygen for individuals that are enrolled in a federally approved clinical trial that is sponsored by the National Heart, Lung and Blood Institute.

Under the current Medicare statutes, Medicare only pays benefits for individuals that have a partial pressure measurement at or below 55mmHg or an oxygen saturation that measures in at or below 88 percent. If another disease or medical condition is present, Medicare will provide benefits if the partial pressure and oxygen saturation are raised one percent. So partial pressure would begin at 56 mmHg and oxygen saturation values would begin coverage at 89 percent.

The threshold for Medicare payments would be raised from 56 to 65 mmHg or whose oxygen saturation is at or above 89 percent. This will enable many people who do not currently meet Medicare coverage requirements to now receive benefits for home oxygen use.

If your physician and has a lot of Medicare medical billing, and your practice has become so busy that your staff is having trouble keeping up, it may be time to consider outsourcing your medical billing to an outside company. Not only will your medical billing partner file your claims in a timely fashion, you will see a faster turnaround on your reimbursements even from Medicare filings.

View all Articles by: Melissa Clark, CCS-P