This is a zip file for download. CPT® license agreement required. 2017 Final Rule OPPS Addenda – Opens in a new window (The 2017 Inpatient Only List is here as Addendum E.) It is available as an Excel file or as a Text file. For additional information on the OPPS Final Rule see this document.
Appeal of Claims Decision : CMS Manual System: Pub 100-04: Chapter 29 This 100 page document contains detailed information regarding the appeals process. Additional information is available in the Federal Register for January 17, 2017.
This 49 page document is produced by CMS as a reference guide for Physicians and coders. Click to read or download. 1997 Guidelines for Evaluation and Management
This 16 page document is produced by CMS as a reference guide for Physicians and coders. Click to read or download. 1995 Guidelines for Evaluation and Management
CMS has finalized rules governing home health agencies that will improve the quality of health care services for Medicare and Medicaid patients and strengthen patients’ rights. These Medicare and Medicaid Conditions of Participation are the minimum health and safety standards a home health agency must meet in order to participate in the Medicare and Medicaid […]
Links to the CMS data: CY 2017 PFS Final Rule Addenda [ZIP, 1MB] CY 2017 PFS Final Rule Sample PE Worksheet [ZIP, 74KB] CY 2017 PFS Final Rule Direct PE Inputs [ZIP, 6MB] CY 2017 PFS Final Rule Indirect Practice Cost Indices [ZIP, 11KB] CY 2017 PFS Final Rule Physician Time [ZIP, 628KB] CY […]
Visit IRF Compare View the CMS Fact Sheet about IRF Compare
AHA RACTrac Initiative The American Hospital Association’s (AHA) RACTrac survey collects data from hospitals on a quarterly basis to assess the impact the Medicare Recovery Audit Contractor (RAC) program on hospitals nationwide. AHA developed RACTrac in response to the lack of data and information provided by CMS on the impact of the RAC program on […]
Place of Service Codes for Professional Claims Database (updated November 2016) Listed below are place of service codes and descriptions. These codes should be used on professional claims to specify the entity where service(s) were rendered. Check with individual payers (e.g., Medicare, Medicaid, other private insurance) for reimbursement policies regarding these codes. If you would like […]