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As flu season continues, stay up to date on the current national, non-facility pricing of influenza vaccines. The table below conveys 2023-2024 payment allowances on oft-reported vaccines, along with coding details. Also, don't forget to add an M code when performing in-home vaccinations.
 
 
The CDC recently released tabular addenda changes to the ICD-10 code set, effective April 1. Among the changes are revisions to the “Excludes 2” note found under J45 (Asthma).
 
 
CMS reverses course and creates frequency limits for prolonged service codes G0316-G0318.
 
CMS has not released a final national coverage determination (NCD) for pre-exposure prophylaxis (PrEP) to prevent human immunodeficiency virus (HIV). And CMS did not discuss the service in the physician fee schedule final rule. But practices and clinics can find previews of the service in the 2024 HCPCS update, the relative value units (RVU) file for the 2024 Medicare and appendix B of proposed decision memo CAG-00464N.
 
The conversion factor cuts that CMS floated earlier in the year are now confirmed – and heightened. Part B providers will have to prepare for a net 3.4% payment decrease across services in 2024, according to the final 2024 Medicare physician fee schedule released today.
 
Also, you will find new services moving to active status, such as caregiver training and principal illness navigation, a one-year telehealth parity patch, key value-based care updates and the launch of the much anticipated add-on complexity code G2211.
 

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