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To help with this transition to potentially requiring use of the KX modifier for claims submission for dental services inextricably linked to covered medical services beginning in 2025, practitioners now have the option to utilize the KX modifier as proposed, for services with dates of service in CY 2024

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In calculating expenditures for Medicare FFS beneficiaries used in Shared Savings Program calculations, CMS uses payment amounts included on Parts A and B FFS claims with dates of service in the relevant benchmark or performance year, allowing for a 3-month claims run out, as follows: claim payment amounts identified for inpatient, Skilled Nursing Facility (SNF), outpatient, Home Health Agency (HHA), and hospice claims at any provider

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Spending at least 48 hours drug-free is recommended to be on the safe side, especially if you are a heavy user