Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organizations; Quality Improvement Organizations; Electronic Health Records (EHR) Incentive Program; Provider Reimbursement Determinations and Appeals This proposed rule would revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) […]
This document corrects technical, typographical, and cross-referencing errors in the final rule that appeared in the May 23, 2013 Federal Register titled “Medicare Program; Medical Loss Ratio Requirements for the Medicare Advantage and the Medicare Prescription Drug Benefit Programs.” View this Final Rule in the Federal Register for July 22, 2013 View the preceding Final Rule […]
FY 2014 Payment Update The proposed rule would increase IPPS operating rates by 0.8 percent after accounting for inflation and other adjustments required by the law. This proposed increase also reflects a proposed temporary reduction of 0.8 percent to implement the American Taxpayer Relief Act’s requirement to recoup overpayments from prior years as a result […]
The proposed rule updates hospital Part B inpatient billing policy consistent with the statute and payment regulations: When the Medicare review contractor denies a Part A claim because a hospital inpatient admission is not reasonable and necessary, Medicare would accept new, timely filed Part B inpatient claims and provide payment for all reasonable and […]
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RAC Focus: IP DRGs for Skin Procedures
Procedures That Will be Paid Only as Inpatient for CY2013 This is a zip file for download. CPT® license agreement required. CY2013 OPPS Addenda [ZIP, 2.1 MB] (The 2013 Inpatient Only List is here as Addendum E.)