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2021 New Year Brings Important Medicare Changes

Medicare
Rebecca Scott
in Medicare
By Rebecca Scott CPC CPCO

2021 New Year Brings Important Medicare Changes

As the year ends, we can reflect on what worked, what didn’t (2020---OMG!) and look forward to the inevitable changes for 2021. It’s a great time to review compliance policy and procedures and to review and revise financial and billing policies. Accounts receivable clean-up is a common process in December, and it’s important to review and update Medical Review Policies. This way, you will be prepared to hit the ground running in 2021.

New Medicare Deductible 2021

The Centers for Medicare and Medicaid Services (CMS) has released the 2021 annual deductible and standard monthly premium for Medicare Part B patients. The annual deductible for all Medicare Part B beneficiaries is $203 in 2021, an increase of $5 from the 2020 annual deductible of $198. This means that all Part B allowed fees are the patient’s responsibility until this deductible is met.

The standard monthly premium for Medicare Part B enrollees will be $148.50 for 2021, an increase of $3.90 from $144.60 in 2020.

Open Enrollment Time

Open enrollment happens at the end of every calendar year. For Medicare Patients, the opportunity to convert from Medicare Part B to a Medicare Part C plan (or vice versa) ended in early December. But Providers have a chance to change enrollment status from Participating to Non-Participating (or vice versa) through the end of December. If you intend to make that change, be sure you do so by year’s end.

Here at KMC University, we recommend that you verify all patients’ insurance on their first visit of the year. Medicare Patients may have elected to convert to a Part C/Medicare Advantage plan and may not understand that they no longer have traditional Medicare Part B benefits. Allow for some extra time to discuss these changes if necessary.

Remember that since 2007 a beneficiary’s Part B monthly premium is based on his or her income. The total premiums for high-income beneficiaries for 2021 are in the enclosed notification for the CMS website.

Click here to review the entire notification.

New ABN Form and QMB Changes Become Mandatory 1/1/2021

Our existing ABN form expired back in March 2020, but when the new one came out in June, the government allowed us to ease into the transition. Mandatory use of the mandatory ABN is now slated for January 1.

  • If you do not have a copy of the new master form yet, click here to download a customizable template from the Medicare website. KMC University members click here for pre-filled, customizable templates for each required type of ABN and all the instructions you'll need. 
  • Non-Participating providers, please remember to strike the appropriate sentence from Option One on your ABN master template that is not applicable to Non-Par providers not accepting assignment.
  • Remember to review the new details for Qualified Medicare Beneficiary (QMB) rules that must be followed with special ABN templates beginning in the new year.

Review these several ABN Helpdesk Videos and Updates if you need a refresher. KMC University Library Members click HERE to access the full ABN training and resources from KMC University.

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Rebecca Scott is a Certified Professional Coder who began her chiropractic career in 1989. She graduated in 2008 with an Associate’s Degree in Accounting and is a Licensed Clinical Chiropractic Assistant in the state of Maine. She’s a member of the Lewiston Chapter of the American Association of Professional Coders (AAPC) and is both a certified specialist working in curriculum development and an individual client consultant for KMC University. She or any of her teammates can be reached at info@kmcuniversity.com or by calling 855-832-6562.

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