2023 Home Health Prospective Payment System Rate Update

On , in Announcements, Documents, by AQ-IQ LLC

This proposed rule would set forth routine updates to the Medicare home health and home infusion therapy services payment rates for calendar year (CY) 2023 in accordance with existing statutory and regulatory requirements. This proposed rule discusses home health utilization; proposes a methodology for determining the difference between assumed versus actual behavior change on estimated […]

June, 2022, New Codes for COVID-19: Pfizer-BioNTech Vaccines for Children as Young as 6 Months

On , in Documents, by AQ-IQ LLC

On June 17, 2022, the FDA amended the Pfizer-BioNTech COVID-19 vaccine emergency use authorization (PDF) to authorize use for all patients 6 months – 4 years old. Get important vial and dosing information. CMS issued new CPT codes effective June 17, 2022: Code 91308 for vaccine product: Long descriptor: Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease […]

IPPS and LTCH Proposed Rule FY2023

On , in Documents, by AQ-IQ LLC

On April 18, 2022 the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule (CMS-1771-P) that provides updates to the fiscal year (FY) 2023 Long-Term Care Hospital Quality Reporting Program (LTCH QRP). This rule includes three Requests for Information (RFI) which include: future measure concepts for the LTCH QRP; inclusion of the new […]

March 2022 New COVID Codes

On , in Documents, by AQ-IQ LLC

On March 29, 2022, the FDA amended the Moderna COVID-19 vaccine emergency use authorization (PDF), including new packaging for vaccine boosters (blue cap). CMS issued new codes, effective March 29, 2022, for the vaccine booster and administration: Code: 91309 Long descriptor: Severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative free, […]

IRF PPS Proposed Rule FY2023

On , in Documents, by AQ-IQ LLC

For FY 2023, CMS is proposing to update the IRF PPS payment rates based on the proposed IRF market basket update less a productivity adjustment. CMS is proposing a permanent cap on year-to-year wage index decreases. Additionally, CMS is soliciting comments on the methodology used to update the IRF facility level adjustments (specifically, the rural, […]

Physician Fee Schedule CY2022

On , in Documents, by AQ-IQ LLC

CMS issued the CY 2022 Medicare Physician Fee Schedule (PFS) final rule that updates payment policies, payment rates, and other provisions for services. This is a summary of key provisions, effective on or after January 1, 2022: Revises telehealth services under the Consolidated Appropriations Act, 2021; allows use of audio-only communications technology when furnishing mental health services […]

NCCI Resources

On , in Documents, by AQ-IQ LLC

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. Visit the NCCI main page on the CMS site. National Correct Coding Initiative Policy Manual for […]

IRF PPS Final Rule FY2022

On , in Documents, by AQ-IQ LLC

The IRF prospective payment system (IRF PPS) Addenda along with other supporting documents and tables referenced in this final rule are available on the CMS website . Prior to 2020, each rule or notice issued under the IRF PPS has included a detailed reiteration of the various regulatory provisions that have affected the IRF PPS […]

CMS Inpatient Only List CY2022

On , in Documents, by AQ-IQ LLC

The 2022 List of inpatient only codes is Appendix E of the OPPS Final Rule. Table of contents for the Addenda (PDF) All the Addenda are available in a .zip file from CMS (click here to download)