Wiki Medicare Advantage Guidelines for CC Hours

[dalejrsgirl83@comcast.net]

Hello,

Does anyone know if Medicare Advantage plans follow the same guide lines as Medicare when it comes to coding for critical care hours. Thanks!

 

[antoniamay]

Hello,

Does anyone know if Medicare Advantage plans follow the same guide lines as Medicare when it comes to coding for critical care hours. Thanks!

So just as a general rule all Medicare Plan Sponsors have to at minimum cover what Medicare does, but they each are allowed to cover over and above what Medicare does in order to entice more members to sign up with their plans however that’s usually extra vision or dental coverage or maybe a gym membership. So they vary on coverage depending on the plan, however they probably stick to the MAC guidelines for critical care hours. Do you know which MAC it is?

 

[dalejrsgirl83@comcast.net]

So just as a general rule all Medicare Plan Sponsors have to at minimum cover what Medicare does, but they each are allowed to cover over and above what Medicare does in order to entice more members to sign up with their plans however that’s usually extra vision or dental coverage or maybe a gym membership. So they vary on coverage depending on the plan, however they probably stick to the MAC guidelines for critical care hours. Do you know which MAC it is?

Thank you! I was trying to find out for each of the MAC plans in Maryland.

 

[antoniamay]

If you’re in Maryland you’re Jurisdiction J so Novitas would have them on their site!

I’m not sure the plans themselves would use different times unless you’re getting a specific denial.

https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00081590

 

[dalejrsgirl83@comcast.net]

If you’re in Maryland you’re Jurisdiction J so Novitas would have them on their site!

I’m not sure the plans themselves would use different times unless you’re getting a specific denial.

https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00081590

Thank you!