The recordings and slide deck from this webinar will be sent to all those that registered. An FAQ is also being compiled to include questions from the Billing Workshop Part 1 as well as this Billing Workshop Part 2 and when finalized, will be sent to all those that registered for either webinar.

MDPP PFS FAQ: https://www.cms.gov/newsroom/fact-sheets/final-policies-medicare-diabetes-prevention-program-mdpp-expanded-model-calendar-year-2022-medicare

MDPP PFS: https://www.federalregister.gov/public-inspection/2021-23972/medicare-program-cy-2022-payment-policies-under-the-physician-fee-schedule-and-other-changes-to-part

That is amazing news!

For questions directly for CMS, visit the Medicare Diabetes Prevention Program (MDPP) Supplier Support Center: https://cmsorg.force.com/mdpp/)

Please type any questions that you have into chat or in the Q&A.

The recordings and slide deck from this webinar will be sent to all those that registered. An FAQ is also being compiled to include questions from the Billing Workshop Part 1 as well as this Billing Workshop Part 2 and when finalized, will be sent to all those that registered for either webinar.

Does it matter whether typing in all caps or mixed as you have?

so box #4 is incorrect? says last name, first name....

So in that case we would use both codes?

As a FQHC would we use the FQHC pos 50?

Can we submit these services via UB format?

where can I find the mdpp fee schedule? is there one? we are new MDPP providers

I have been directed not to log G-Code G9891 alone because there is no charge. Is that something I should discuss with my MAC?

added and approved

We do not need to put a name?

Thank you for all of the great questions! Keep them coming. If we are unable to answer them during this webinar we will send them out in an FAQ that will be distributed to all registrants. You can enter questions in chat or Q&A.

why wouldn't you put in ythe DPP actual charge for service, because that is the 'actual' charge?

Is there a template of the informed consent form?

Can we submit these services via UB or should we bill them on HCFA

2, 3, 4 need to be on the same claim?

Billing and Claims Webinar Slides Link: https://innovation.cms.gov/media/document/mdpp-model-getting-started-billing-claims-fs

box 26 is not the internal system account #

If you use a thrid-party biller do they use their address? for 33?

so box 26 is our internal account # for the client. Not the Medicare policy # correct

If one coach leads for Session 2 but a different coach leads for 3 or 4, which NPI number should we use?

So when payment comes in we have to locate the claim in our internal system by name. This will be difficult for electronic posting.

On #33 we put the RD as the billing provider like we do with DSMT. I'm guessing after learning today that claim will be rejected because we need to change it to our MDPP NPI?

CMS Billing and Claims Webinar Link: https://innovation.cms.gov/media/document/mdpp-model-getting-started-billing-claims-fs

How do you verify that your coach is updated in PECOS

So if a beneficiary is unable to make it to the 2nd session you would be unable to bill for any classes the rest of the series?

Do you still include a previous HCPC code on subsequent billing with no payment cost attached? For example, if you previously submitted a claim for attending 1 session, then on the next claim, submitted for attending 4 sessions, do you still list the session 1 code + date?

you receive a verification notice from your MAC, or Pecos, if the updated app us approved

To repeat, box 22 should state 7 (not 9)

Under box 21, the worksheet states that we enter "10" for ICD. Your example shows that we enter "0". Which is correct?

Use of a Vendor/Third Party Billing Agent: Many providers and suppliers use a billing agent to manage billing and payment processes on their behalf. If an MDPP supplier uses a billing agent, the billing agent’s information must be listed on the MDPP Enrollment Application: https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS20134.pdf

Self-Submit Claims: If an MDPP supplier does not use a billing agent, the MDPP supplier can submit claims to its MAC directly. The MDPP supplier must install claims software and obtain a submitter ID from the MAC(s). Organizations may obtain PC-Ace Pro 32 claims submission software http://www.edissweb.com/cgp/software/pcace.html or other recommended software from their MACs.

Will we be able to status these claims through FSS0 or ConneX ?

If Self-Submit, how do we submit Medicare Advantage plans?

Thank you for all of the great questions! Keep them coming. If we are unable to answer them during this webinar we will send them out in an FAQ that will be distributed to all registrants. You can enter questions in chat or Q&A.

A reminder the slides, webinar recording link, and FAQ will be sent after the webinar (not right after, but soon) to all registrants.

Searchable link for CARCs: https://x12.org/codes/claim-adjustment-reason-codes

2022 PFS (MDPP starts on page 961): https://www.federalregister.gov/public-inspection/2021-23972/medicare-program-cy-2022-payment-policies-under-the-physician-fee-schedule-and-other-changes-to-part

This was very helpful. Thank you.

You are awesome Cass! Thank you so much

Thank you!

Are submitting this service on HFCA or UB

Thank you Cassi!

Thank you!

This was very helpful. Thank you.

What is the best way to verify beneficiary eligibility for MDPP.

Thanks. Nanc

Thank you so much!

Remember, the slides, webinar link, and the FAQ will be coming to all registrants. THANK YOU for attending!

Thanks!