After multiple extensions, the COVID-19 public health emergency (PHE) is slated to end on May 11. This conclusion will likely bring discomfort to some patients and case managers.
Critical access hospitals (CAH) and rural health clinics (RHC) provide vital services to their communities, but even in the best of times they can face serious revenue challenges. Ensure these vital facilities are supported by correct, complete billing practices.
CMS issued the final rules for the 2023 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital Prospective Payment System (LTCH PPS) on August 1 and, like the proposed 2023 OPPS proposed rule, there aren’t any big surprises this year.
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.
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.
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.
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.
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.
U.S. District Court Judge Rudolph Contreras will hold a hearing December 21 for a lawsuit aimed at halting the CMS payment reduction for hospital outpatient drugs acquired through the 340B program, a policy set to go into effect January 1.
