Medicare Benefits and Coverage Overview

Medicare benefits are available to individuals in how many beneficiary categories?

Hospice care is covered under:

Which of the following is also called Supplemental Medical Insurance?

Which Medicare Part offers a prescription drug plan?

IPPE is the abbreviation for:

What is the abbreviation for annual wellness visit?

Medicare may classify conditions that are not covered as:

LCD is the abbreviation for:

Physicians who do not participate in the Medicare program agree to not accept the Medicare Fee Schedule charge amount as full payment for services.

What does the abbreviation MSA stand for in the Medicare program?

Medicare Administrative Contractors (MACs) process Medicare claims for which of the following?

In what year did Medicare stop paying for all consultation codes from the CPT evaluation and management, except for telehealth consultation G-codes?

Roster billing is used to file simplified claims for certain:

CLIA is the abbreviation for:

If a paper claim and a HIPAA 837P claim are sent on the same day, which of the following is true?

Which part of Medicare provides voluntary Medicare prescription drug plans?

Services supervised by the physician but provided by nonphysician practitioners are billed under:

Under the Medicare program, if the approved amount for a procedure is $100, the participating physician will be paid $100 (by Medicare and the patient), and the nonparticipant who accepts assignment will be paid:

All laboratory work paid for by Medicare is regulated by:

CMS accepts only signatures that are:

Medicare Benefits and Coverage

Six beneficiary categories are eligible for Medicare benefits.
Hospice care is included in Medicare Part A coverage.
Medicare Part B is also known as Supplemental Medical Insurance.
Medicare Part D offers a prescription drug plan.

Preventive Services

IPPE stands for initial preventive physical examination.
AWV is the abbreviation for annual wellness visit.

Coverage Classifications

Conditions not covered by Medicare may be classified as "not medically necessary."
LCD stands for local coverage determination.

Physician Participation and Claims Processing

Non-participating physicians in Medicare agree not to accept full payment via the Medicare Fee Schedule.
Medical Savings Account (MSA) is a term used in the Medicare program.
Medicare Administrative Contractors (MACs) are responsible for processing claims for Medicare beneficiaries.

Policy Changes and Claims Submission

In 2010, Medicare ceased payment for all consultation codes from the CPT evaluation and management, apart from telehealth consultation G-codes.
Roster billing is utilized for simplified claims associated with certain Medicare immunization programs.
CLIA refers to Clinical Laboratory Improvement Amendments, regulating laboratory work paid by Medicare.

Claims and Payment Procedures

If both a paper claim and a HIPAA 837P claim are submitted on the same day, the HIPAA 837A claim will be processed first.
Medicare Part D provides voluntary prescription drug plans.
Services supervised by physicians but performed by non-physician practitioners are billed under "incident to" rules.
A participating physician receives the full approved amount (e.g., $100) while a non-participant accepting assignment will receive 95% of that amount ($95).

Compliance and Signature Requirements

All laboratory work funded by Medicare must adhere to CLIA regulations.
CMS mandates acceptance of only correct signatures as valid for claims and documentation.

Explore the essentials of Medicare benefits and coverage in this quiz. Learn about the various beneficiary categories, the components of Medicare, and crucial terms related to preventive services and claims processing. Test your knowledge on how Medicare functions and recent policy changes.