Update on M Factor Fee Schedule Discussed in Former Alert Dated 8/27/20
Date: 06/15/21
Iowa Total Care would like to update providers regarding a previous provider alert dated 8/27/20.
ITC has done a full review of M factor codes and has identified various rates that were missing or incorrect. The system has been updated as of 4/30/2021. Any claims that were paid incorrectly prior to this date will be reprocessed by 6/15/2021.
Hearing aid dealers and other hearing aid related providers were among those impacted by this issue. As noted previously submitted claims paid incorrectly were also included in the reprocessing activities above. The corrected rates have been set as follows, effective 7/15/2020:
| Procedure Code | Rate | Procedure Code | Rate |
|---|---|---|---|
A4649 | $264.57 | V5150 | $500.00 |
V5014 | $117.74 | V5181 | $1,035.00 |
V5050 | $520.53 | V5211 | $1,437.00 |
V5060 | $728.62 | V5221 | $1,578.44 |
V5130 | $957.15 | V5267 | $34.10 |
V5140 | $1,138.75 | V5286 | $249.00 |
V5299 | $166.95 |
Iowa Total Care recognizes that the cost of M Factor supplies and services can vary. If the ITC rate assigned for these procedure codes does not cover your cost, you may submit your invoice through the dispute process outlined in the Iowa Total Care Billing Manual for review and reconsideration.
M Factor rates are updated annually on July 1st.
For questions or concerns, contact your Provider Relations Specialist.