October 2001

The JCAAI wants to remind you that there have been NO CHANGES to the Medicare ruling implemented January 1, 2001.

For reimbursement purposes only - a dose equals 1cc aliquots of maintenance dose extract, i.e., if you prepare a 10cc vial of extract for your patient, you would bill- 95165 and put 10 in the "Units" box. You may only be administering .5cc per injection, which means your patient will actually receive 20 doses from the vial, but you can only bill Medicare for 10. You CAN bill for the administration of every injection -95115 for one injection; 95117 for two or more injections. Medicare has said that we may only bill for 10 cc's per vial.

We recommend you prepare "treatment sets" of extract for Medicare patients. By preparing the extract in this manner, if you are ever audited by Medicare, you will easily be able to prove you billed only for the concentrate (maintenance dose) extract.

You can bill up to a 12 month supply of extract . can only bill ten (10) 1 cc aliquots out of each Vial, If you bill for , 12 months, you actually will have to prepare another vial with 2 cc's of concentrate if you want to bill for 12 month supply.

However, you are not required to only bill once per year. You can bill as many times as you prepare maintenance dose extract for your Medicare patient.