Enhanced Reimbursement in GA UPDATE
Jan 17, 2019 15:43:19 GMT -5
John Craine and Tanya Munroe like this
Post by Mary Fitzmaurice on Jan 17, 2019 15:43:19 GMT -5
For those interested in updates on enhanced reimbursement for GA, this is what we currently know.
CareSource Enhanced Reimbursement (GA)
-$30/patient/Centering visit capped at $300.
-CPT code 99078 with TH modifier
-Some issues reported from the sites with getting paid; possible the wrong diagnosis codes being used
-Any Centering site in GA can use these codes, and Dr Seema Csukas made her information available to be contacted directly if there are any issues
-SEEMA CSUKAS, MD, PhD, FAAP
Medical Director, Georgia Market
600 Galleria Parkway, Suite 400
Atlanta, GA 30339
p: 678.214.7520 | c: 470.423.6091
Seema.Csukas@CareSource.com
DCH CenteringPregnancy Incentive Pilot Program
Budget is $500,000 for 1 year
4 sites selected by DCH, going live 2/18/19
Reimbursement is $100/patient/Centering session capped at $1000 per member. There's an additional $25/patient/Centering session that goes to the CMO likely for administrative fees, but could be passed on at their discretion to the patient. Funding will run through the CMO's. CPT code 99078 with TH modifier. If it's a Care Source member, they will get this benefit and not the above mentioned reimbursement.
They are somewhat modeling SC in regards to the outcomes they are looking at. They increased the payment to encourage better site sustainability.
The 4 sites selected are: Grady, Southside Lovejoy, Dougherty, and Upson.
CareSource Enhanced Reimbursement (GA)
-$30/patient/Centering visit capped at $300.
-CPT code 99078 with TH modifier
-Some issues reported from the sites with getting paid; possible the wrong diagnosis codes being used
-Any Centering site in GA can use these codes, and Dr Seema Csukas made her information available to be contacted directly if there are any issues
-SEEMA CSUKAS, MD, PhD, FAAP
Medical Director, Georgia Market
600 Galleria Parkway, Suite 400
Atlanta, GA 30339
p: 678.214.7520 | c: 470.423.6091
Seema.Csukas@CareSource.com
DCH CenteringPregnancy Incentive Pilot Program
Budget is $500,000 for 1 year
4 sites selected by DCH, going live 2/18/19
Reimbursement is $100/patient/Centering session capped at $1000 per member. There's an additional $25/patient/Centering session that goes to the CMO likely for administrative fees, but could be passed on at their discretion to the patient. Funding will run through the CMO's. CPT code 99078 with TH modifier. If it's a Care Source member, they will get this benefit and not the above mentioned reimbursement.
They are somewhat modeling SC in regards to the outcomes they are looking at. They increased the payment to encourage better site sustainability.
The 4 sites selected are: Grady, Southside Lovejoy, Dougherty, and Upson.
