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Medicare Billing Updates Effective January 1, 2022
1/12/2022 • Posted by Provider Relations

The Centers for Medicare and Medicaid (CMS) have released several billing changes and updates for various Medicare services that take effect on January 1, 2022. As a valued Wellcare By Fidelis Care provider partner, we want to make you aware of how these changes will impact your billing activities with us in 2022.

COVID-19 Vaccination Claims

  • Effective January 1, 2022, providers may submit Medicare claims for COVID-19 vaccines and their administration directly to Wellcare By Fidelis Care for payment.
  • Previously, COVID-19 vaccination claims were submitted directly to Medicare Fee-for-Service. For dates of service 1/1/22 and after, Wellcare By Fidelis Care will now process and adjudicate all COVID-19 vaccination claims for its Medicare members.
  • We will employ the reimbursement rates as they are established by CMS and our state regulators in accordance with provider contract terms for COVID-19 vaccine payments.

New/Modifications to the Place of Service (POS) Codes for Telehealth Services

  • Effective for dates of service January 1, 2022 and after, CMS is revising the description of POS code 02 and adding POS code 10 for telehealth services to meet the overall industry needs.
    • POS 02: Telehealth Provided Other than in Patient’s Home
      • Patient is not located in their home when receiving health services or health related services through telecommunication technology.
    • POS 10: Telehealth Provided in Patient’s Home
      • Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology.
  • Claims adjudication for POS 10 will begin in January 2022 & Wellcare By Fidelis Care will adjust claims as needed.
  • For more information, please see CMS’ MLN Matters release.

Skilled Nursing Facility (SNF) Interim Billing Update

  • Effective January 1, 2022, Wellcare By Fidelis Care will accept and adjudicate interim bills from SNFs for our Medicare members.
  • No final bill is required.

Thank you for continuing to provide our Medicare members with high quality and compassionate care. If you have questions about any of these billing changes, please contact our Call Center at 1 (888) 343-3547 or contact your Provider Relations Specialist.

 

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