How should Medicare Advantage plans submit encounters for a supplemental gym membership?


Answer:

MAOs are responsible for determining the best way to complete the encounter data record. Not all HCPCS codes reported on encounter data records need to be Medicare A or B services, but they should be valid HCPCS codes that are appropriately related to the service provided. You can access the full list of Medicare HCPCS by using this link: https://www.cms.gov/Medicare/Coding/MedHCPCSGenInfo/index.html and a full list of all HCPCS codes can be found.


Last Updated: 09/01/2019