OPPS

As hospitals continue to struggle to comply with hospital price transparency requirements, HHS has been tasked with updating guidance and enforcement efforts.

Explore the importance of integrating social determinants of health (SDOH) into the healthcare framework and coding processes.

Learn about the new codes for chimeric antigen receptor T-cell (CAR-T) cell collection and cell processing in the 2025 Outpatient Prospective Payment System proposed rule.

Case managers should familiarize themselves with CMS' behavioral health policies to ensure they continue to provide high-quality patient care.

Review some of the provisions in the 2025 Outpatient Prospective Payment System (OPPS) proposed rule that could directly impact your organization.

Unpack the 2025 Outpatient Prospective Payment System (OPPS) proposed rule to see what adjustments could be in store for case managers.

CMS recently finalized a multitude of new price transparency requirements in the 2024 Outpatient Prospective Payment System (OPPS) final rule. These requirements have staggered enforcement deadlines, which means that revenue integrity professionals have their work cut out for them in the coming year to ensure their organization is in compliance. 

Make sure staff who handle audit requests understand when a missing signature should — or should not — trigger an automatic denial of your claims or prior authorization requests. Recent guidance from CMS clarifies how auditors should proceed when a medical record lacks a signature.

Rabies is a viral disease that affects the central nervous system. Refresh on reporting protocols for rabies exposure and treatments in ICD-10-CM.