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IRF PPS Final Rule FY2021

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CMS issued the annual update for the Inpatient Rehabilitation Facility Prospective Payment System on August 4, 2020. This final rule also includes making permanent the regulatory change to eliminate the requirement for physicians to conduct a post admission visit since much of the information is included in the pre-admission screening documentation. This flexibility was offered […]

OPPS Proposed Rule CY2021

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On August 4, 2020, the CMS proposed policies that aim to increase choice, lower patients’ out-of-pocket costs, empower patients, and protect taxpayer dollars. These proposed changes would build on existing efforts to increase patient choice by making Medicare payment available for more services in different sites of service and adopting policy changes under the Medicare […]

CMS Beneficiary Notices

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Both Medicare beneficiaries and providers have certain rights and protections related to financial liability under the Fee-for-Service (FFS) Medicare and the Medicare Advantage (MA) Programs. These financial liability and appeal rights and protections are communicated to beneficiaries through notices given by providers. Hospitals are required to deliver the Important Message from Medicare (IM), CMS-R-193 to all […]

ICD-10-PCS FY2021

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2021 ICD-10-PCS The 2021 ICD-10 Procedure Coding System (ICD-10-PCS) files below contain information on the ICD-10-PCS updates for FY 2021. These 2021 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2020 through September 30, 2021. Note: There is no GEMs file. As stated in the FY 2016 IPPS/LTCH PPS final rule (80 […]

MLN Matters Articles Index, FY2004 – FY2019

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What is MLN Matters? The Centers for Medicare & Medicaid Services (CMS) is committed to partnering with the Medicare physician, provider, and supplier communities to ensure that Medicare beneficiaries receive all of the health care services to which they are entitled. MLN Matters are national articles designed to inform the physician, provider, and supplier community […]

CY2021 ESRD Proposed Rule

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On July 6, CMS issued a proposed rule that proposes to update payment policies and rates under the End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) for renal dialysis services furnished to beneficiaries on or after January 1, 2021. This rule also proposes updates to the Acute Kidney Injury (AKI) dialysis payment rate for renal […]

CY2021 Home Health Proposed Rule

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On Jun 25th CMS issued a proposed rule [CMS-1730-P] that proposes routine updates to the home health payment rates for calendar year (CY) 2021, in accordance with existing statutory and regulatory requirements. This proposed rule also includes a proposal to make permanent the regulatory changes related to telecommunications technologies in providing care under the Medicare […]

COVID-19 FAQs from CMS

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Recommendations for re-opening facilities for non-emergent non-COVID-19 healthcare CMS Press Releases on COVID-19 April 30, 2020 Update April 27, 2020 Update April 14, 2020 Update Open Payments Program FAQ (Apr 3, 2020) March 30, 2020 Update On March 6, 2020, the Centers for Medicare & Medicaid Services (CMS) issued frequently asked questions and answers (FAQs) […]

Modifier CR and DR during COVID-19

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Clarification on the DR (disaster related) and CR (catastrophe/disaster related) modifiers was issued by CMS on June 1, 2020 in this document.  The clarifications are the only changes made to this guidance.