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Weeks after finalizing payment rates and policy changes affecting Medicare services furnished in hospital outpatient and Ambulatory Surgical Center (ASC) settings for calendar year (CY) 2022, the Centers for Medicare & Medicaid Services (CMS) released updates to the ASC payment system, effective Jan. 1, 2022. Make sure your billing staff knows about these changes. January […]
The post ASC Payment System Updates: January 2022 appeared first on AAPC Knowledge Center.
CMS dramatically increases financial penalties for noncompliance with hospital price transparency rules. On Nov. 2, 2021, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule, finalizing payment rates and policy changes affecting Medicare services furnished […]
The post 2022 OPPS/ASC Final Rule Finalizes 2% Boost in Payment Rates appeared first on AAPC Knowledge Center.
Latest Medicare rule changes aim to increase payment rates and improve health equity and quality of care for those with end-stage renal disease. On Oct. 29, 2021, The Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates payment rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal […]
The post CMS Announces Changes to ESRD Payment Model appeared first on AAPC Knowledge Center.
The effects of COVID-19 are still being felt in the states and influencing the Centers for Medicare & Medicaid Services’ (CMS’) decisions for policy changes, as evident in the 2022 Medicare Physician Fee Schedule (MPFS) proposed rule. Released mid-July, the proposed rule focuses on righting various shortcomings in healthcare that were highlighted during the ordeal […]
The post CMS Proposes MPFS Payment Policies for 2022 appeared first on AAPC Knowledge Center.
Proposed rule improves payment rates, incentives, and ESRD treatment choices. Disadvantaged Medicare patients suffer from end-stage renal disease (ESRD) at higher rates and are also more likely to be readmitted to hospitals, experience higher costs, and receive in-center hemodialysis when their kidneys are no longer able to function properly. Furthermore, non-white patients with ESRD are […]
The post CMS Forecasts Increase in Dialysis Payment, Health Equity Gap Reduction appeared first on AAPC Knowledge Center.
The 2016 OPPS final rule includes the first negative payment update for the system, but CMS also listened to commenters’ suggestions to make a variety of proposals less onerous either operationally or financially.
CMS selects primary care payment model participants
According to Becker’s Hospital Review, “CMS chose 916 primary care practices and 37 regional health plan partners as participants in its new payment model called Primary Care First.
PCF was designed to decrease the amount of avoidable hospital visits and total cost of care through performance-based adjustments. The practices CMS selected as participants generally include primary care clinicians who serve seriously ill populations in high need of care.
Participants will start using the alternative payment model Jan. 1, 2021, and CMS plans to test the model for five years.”
The post CMS Selects Primary Care Payment Model Participants appeared first on The Coding Network.
42 FAQs clarify the finer points of billing during the three-day payment period. A Dec. 3, 2020, MLN Matters® article reaffirms appropriate billing procedures and compliance associated with the three-day window. The article was prompted by the Office of Inspector General (OIG) May 2020 report Medicare Made $ 11.7 Million in Overpayments for Nonphysician Outpatient Services […]
The post Do You Know Your 3-Day Payment Window Rules? appeared first on AAPC Knowledge Center.
Just in time for new COVID-19 vaccine, administration, and treatment codes.
The post Medicare Finalizes COVID-19 Vaccine Payment Amounts appeared first on AAPC Knowledge Center.
Revised instructions indicate payment status for new CPT codes. The Centers for Medicare & Medicaid Services (CMS) has issued changes to the October update of the 2020 Medicare Physician Fee Schedule Database (MPFSDB) that you do not want to ignore. Among the revisions relayed in MLN Matters 11939, issued Oct. 27, are the anticipated payment […]
The post MPFSDB October Update Clarifies Code Payment appeared first on AAPC Knowledge Center.