UPDATE: March 26, 2020 CMS has launched www.coronavirus.gov for information on COVID-19 Additional guidance may be found on the Current Emergencies page UPDATE: March 18, 2020 The CDC has announced that the effective date for this new code is April 1, 2020. Read the announcement here Responding to the public health emergency of the 2019 […]
One March 6, 2020, the Centers for Medicare & Medicaid Services (CMS) issued frequently asked questions and answers (FAQs) for healthcare providers regarding Medicare payment for laboratory tests and other services related to the 2019-Novel Coronavirus (COVID-19). The agency is receiving questions from providers and created this document to be transparent and share answers to […]
CMS originally developed the Medically Unlikely Edit (MUE) program to reduce the paid claims error rate for Part B claims. The first edits were implemented January 1, 2007. Subsequently there have been quarterly updates increasing the number of edits. In 2008, CMS has been refining the edits based on 100% submitted claims data from a […]
The policies in the final rule will further advance the agency’s commitment to increasing price transparency. It includes requirements that would apply to each hospital operating in the United States. This final rule implements Section 2718(e) of the Public Health Service Act and improves upon prior agency guidance that required hospitals to make public their […]
On November 1, CMS issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective on or after January 1, 2020. Payment Provisions: Ratesetting and conversion factor CMS is finalizing a series of standard technical proposals involving practice expense, including […]
FY 2020 Information IRF-PAI (version 4.0 FINAL) – Effective October 1, 2020 (FY 2021), as proposed in the FY 2020 IRF PPS final rule. Change Table listing differences from the previous version IRF-PAI Manual Version 3.0 – This manual contains information regarding data collection on the IRF-PAI version 3.0, effective October 1, 2019. Please note that the IRF-PAI Manual […]
FY 2018 IRF PPS Final Rule Data Files (82 FR 36238) IRF Rate Setting Final Rule (82 FR 36238) This file contains data for each of the 1,140 inpatient rehabilitation facilities used to estimate the policy updates in the final inpatient rehabilitation prospective payment system regulation. The methodology used to update the payment data is described […]
On October 1, 2015, the ICD-9 code sets used to report medical diagnoses and inpatient procedures were replaced by ICD-10 code sets. The transition to ICD-10 is required for everyone covered by the Health Insurance Portability Accountability Act (HIPAA). Please note, the change to ICD-10 does not affect CPT coding for outpatient procedures and physician services. Click […]
FY2020 Final Rule Data Files Download for FY2020 (zip) includes: IRF Wage Index Final Rule – These files contain the proposed urban and rural Core-Based Statistical Area FY 2020 IRF wage index tables. IRF Rate Setting Final Rule – This file contains data for each of the 1,122 inpatient rehabilitation facilities used to estimate the policy updates in […]