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Providers and DSS debate billing and attribution issues: ultrasounds, recoupment and MFM taxonomy
Summary
Providers asked whether ultrasounds and other maternity services billed before a case‑rate trigger need recoupment and pressed DSS about how Maternal‑Fetal Medicine services will be identified; MedOps said pre‑trigger ultrasounds remain fee‑for‑service and DSS is assessing taxonomy/TIN issues for MFM attribution and will follow up with practices.
Providers raised practical billing questions during the forum about how the maternity case rate interacts with services billed before or outside a trigger claim and how Maternal‑Fetal Medicine (MFM) services will be identified.
A provider asked whether ultrasounds billed before the case‑rate trigger must be recouped when deliveries are rebilled…
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