News & Analysis

August 4, 2020
Medicare Web

Facing the unprecedented COVID-19 public health emergency, CMS released the 2021 OPPS proposed rule later than ever before, with the agency generally reinforcing its recent focus on site-neutral payment policies, lowering reimbursement for drugs purchased under the 340B program, and adding more services to the list of prior authorization. 

March 16, 2020
Medicare Web

Q: Are lab tests included the Comprehensive APC for observation services?

March 9, 2020
Medicare Web

Q: How many hours of observation services must a patient receive before the hospital is required to provide them with the Medicare Outpatient Observation Notice (MOON)?

March 1, 2020
Briefings on APCs

Like other services covered by Medicare, observation must be reasonable and necessary or, in other words, medically necessary. The physician must document that they assessed patient risk to determine that the patient would benefit from observation services.

February 19, 2020
HIM Briefings

The nuances of documenting and billing for observation services can trip up even the savviest organization. Get a refresher on the basics to ensure your organization avoids common pitfalls.

February 10, 2020
Medicare Web

Q: How do we bill Part B for an inpatient stay that our UR committee determined was not medically necessary?