Amidst the hospital-of-the-future buzz at HIMSS18 was keen interest in resources aimed at helping providers navigate the present-day transition to value-based care. Many healthcare executive and clinician attendees were eager to identify ways healthcare technology can help their organizations transition from fee-for-service to pay-for-performance reimbursement models.
CMS reminded organizations to pay attention to billing and coding for specimen validity testing done in conjunction with drug testing. The agency reviewed recent code changes and billing guidelines for these lab tests in Special Edition MLN Matters 18001 released on March 29. CMS emphasized that providers that perform validity testing on urine specimens cannot separately bill the validity testing.
This week’s Medicare updates include a final rule on various policies throughout the Medicare program involving drug pricing, the final 2019 Medicare Advantage rate announcement and call letter, a list of newly added waived test codes, and more!
Medicare Advantage plan payment rates will increase by an average of 3.4% in 2019 due to higher projected per-capita cost growth for Medicare fee-for-service. The final pay bump is significantly higher than the 1.84% increase proposed in the 2019 advance notice.
