This Final Rule addresses the Skilled Nursing Facility Prospective Payment System and Consolidated Billing as well as the SNF Value-Based Purchasing Program, the SNF Quality Reporting Program, and SNF Payment Models Research. Read the Final Rule in the Federal Register for August 5, 2016
CMS projects that Medicare payments to home health agencies in CY 2017 would be reduced by 1.0 percent, or $180 million based on the proposed policies. The proposed decrease reflects the effects of the 2.3 percent home health payment update percentage ($420 million increase); the rebasing adjustments to the national, standardized 60-day episode payment rate, […]
Transmittals for Chapter 1 Part 1 (Sections 10 – 80.12) Transmittals for Chapter 1 Part 2 (Sections 90 – 160.26) Transmittals for Chapter 1 Part 3 (Sections 170 – 190.34) Transmittals for Chapter 1 Part 4 (Sections 200 – 310.1) Crosswalk from NCD Manual to Coverage Issues Manual (CIM) [PDF, 447KB] Crosswalk […]
The Work Plan describes the primary objectives and provides for each review its internal identification code and the year in which OIG expects one or more reports to be issued as a result of the review. Get the PDF (80 pages)
CMS has released updates to the FY2016 Final Rule published August 17, 2015. Both the FY2016 IPPS Final Rule (August 17, 2015) and the corrections (October 5, 2015) are available. Description: We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising […]
This document will be published in the Federal Register on October 16, 2015. The currently available copy is in .pdf format. This final rule finalizes a new edition of certification criteria (the 2015 Edition health IT certification criteria or “2015 Edition”) and a new 2015 Edition Base Electronic Health Record (EHR) definition, while also modifying […]
Procedures That Will be Paid Only as Inpatient for CY2015 This is a zip file for download. CPT® license agreement required. CY2015 OPPS Addenda [ZIP, 2.8 MB] (The 2015 Inpatient Only List is here as Addendum E.) It is available as an Excel file or as a Text file. Effective April 1, 2015, a new […]
Procedures That Will be Paid Only as Inpatient for CY2014 This is a zip file for download. CPT® license agreement required. CY2014 OPPS Addenda [ZIP, 1.8 MB] (The 2014 Inpatient Only List is here as Addendum E.)
CMS Transmittal 1203 dated March 22, 2013 MLN Matters (revised July 6, 2013) These documents provide guidance for billing Part B inpatient claims and the use of condition code W2.