News & Analysis

September 7, 2022
Case Management Monthly

The 2023 OPPS proposed rule is out, and it includes some minor changes to the inpatient-only list and a proposal for a new type of hospital. CMS will now host a public comment period through September 13 before finalizing the rule in early November.

May 1, 2020
News & Insights

CMS released a new interim final rule with comment period that grants organizations another round of flexibilities to meet the challenges of the COVID-19 public health emergency, including permitting hospitals to bill for telehealth services and loosening restrictions on COVID-19 testing.

March 18, 2020
News & Insights

CMS announced blanket waivers of certain Medicare requirements to prevent gaps in care for beneficiaries affected by the novel coronavirus (COVID-19) public health emergency. The agency released billing instructions and a set of Q&As.

April 1, 2018
Briefings on APCs

With the expansion of telehealth services, providers for both the originating site and distant site can also count on the expansion of Medicare contractor audits.

March 14, 2018
News & Insights

Changes to HCPCS and CPT® codes, drug and biological payments, and a new separately payable procedure code are coming in April. The transmittal announcing the updates also includes clarification on the application of the modifier –FY payment reduction.

March 1, 2018
Medicare Insider

This week's note explains and defines various policies enacted by the Bipartisan Budget Act of 2018, including policies related to outpatient therapy caps and the use of modifier -KX; the low-volume hospital adjustment; the Medicare dependent hospital program; and more. Updated March 2, 2018 for clarity on therapy cap exclusions.  

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