In CMS
Jul 17th, 2017
The Centers for Medicare & Medicaid Services (CMS) has a date in mind for implementing the Appropriate Use Criteria (AUC) program for advanced diagnostic imaging services. In the 2018 Medicare Physician Fee Schedule (MPFS) proposed rule, CMS proposes Jan. 1, 2019, as the date when ordering professionals would need to consult specified applicable AUC using a qualified clinician ...
In Billing
Jun 8th, 2017
Although comparing the third quarter 2017 payment amount with the prior quarter reveals that, on average, prices for Part B drugs increased by 0.1 percent, according to the Centers for Medicare & Medicaid Services (CMS), there are several code changes in the July 2017 update that will soon affect claims payment under the Outpatient Prospective ...
Know the impact of this regulation on off-campus hospital departments. Section 603 (Site Neutral Payments Provision) of the Bipartisan Budget Act of 2015 (BBA) reduces Medicare reimbursement for certain off-campus hospital departments by eliminating eligibility for payment under the Hospital Outpatient Prospective Payment System (OPPS). With few exceptions, off-campus provider-based departments tha...
This year sees expanded packaging, encounter-based payments, and off-campus provider-based department changes. By Denise Williams, RN, COC As in past years, the Centers for Medicare & Medicaid Services (CMS) based 2017 Hospital Outpatient Prospective Payment System (OPPS) payments on claims data submitted by hospital providers. This year, that resulted in a 1.65 percent update. Hospitals ...
In Billing
Jan 20th, 2017
If your accounts receivables are higher than expected in first quarter 2017, remember the old adage: If it’s too good to be true, it probably is. Due to errors in the Medicare Claims Processing System, some Outpatient Prospective Payment System (OPPS) hospital claims with dates of service on or after January 1, 2017, may have ...