Part B Insider (Multispecialty) Coding Alert
You Can Receive Shortage Bonus Only For Professional Component
PDF
Notify your Medicare carrier if you choose to bill globally and forgo your physician scarcity (PSA) or health professional shortage area (HPSA) bonus - or your carrier will reject your claims.
Now you can receive PSA and HPSA bonus payments on only the services' professional component with a "1" indicator (Diagnostic Services or Radiology Services), even when you submit a global service code, according to two recent Centers for Medicare and Medicaid Services transmittals. You must bill the professional and technical components separately or your carrier will return your "unprocessable" claim.
Plus: If you don't want to bill the components separately and wish to forfeit your HPSA and PSA incentive payments on globally billed eligible services, your carrier won't perform a HPSA or PSA related post-pay review on those claims. Your carrier will re-open and reprocess your previously billed claims, if you want to receive only the global services payment and not the bonus.
To read CMS' transmittals, go to www.cms.hhs.gov/manuals/pm_trans/ R556CP.pdf or www.cms.hhs.gov/manuals/pm_trans/R559CP.pdf.
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