Medicare AdvantageDocumentationMedium impact
Reviewing Medications With Members
HealthSpring·Provider News
Effective date
Aug 13, 2026
We identified it
Aug 14, 2026
Summary
HealthSpring Medicare Advantage is recommending providers conduct 'brown bag medicine reviews' with patients to verify medication compliance and identify discrepancies. Billing teams should use appropriate CPT Category II codes when submitting claims to document these reviews and close care gaps for CMS Five-Star Quality Rating measures, particularly for Medication Reconciliation Post-Discharge and Medication Review metrics.
Action Required
By August 13, 2026: Billing team must coordinate with providers to identify and apply appropriate CPT Category II codes for medication review services on claim submissions when brown bag medicine reviews are conducted. Update encounter documentation templates to capture medication review activities. Request the Stars Guidebook from HealthSpring representative or access via Availity Essentials to identify specific relevant CPT codes. Provider education is needed on the teach-back method and documentation requirements to support proper coding. Ensure medication lists are updated and included at discharge to support reconciliation claims.