CMS has raised the Medicare payment rate for certain COVID-19 antibody infusions and included a new payment policy for at-home administration, which will have a higher payment rate compared to…
Inpatient hospital stays have become more expensive to the Medicare program. It's a trend that began even before the COVID-19 pandemic. A new report from the Department of Health and…
Phone call codes during the PHE range from 99441 to 99443, and are all based on time. In response to the COVID-19 pandemic, the Centers for Medicare & Medicaid Services…
CMS just issued a correction to its guidance on 2021 Medicare rules for remote physiologic monitoring (RPM) services. The correction is effective January 1, 2021 and revises the preamble commentary in the…
CMS has codified how it defines “reasonable and necessary” coverage for items and services that may be covered under Medicare Parts A and B in a new final rule. The…
Are you prepared for the sweeping changes made to the “traditional” 1995 and 1997 evaluation and management (E/M) guidelines for office and outpatient visit codes you have been accustomed to…
Just a day after the FDA approved the emergency use of a new COVID-19 antibody drug, CMS updated Medicare payment and billing policies to ensure providers have access to the…
Medicare contractors were inconsistent in how they reviewed overpayments during the appeals process, says the Office of Inspector General in a new report. Although MACs and QICs generally reviewed appealed…
Centers for Medicare & Medicaid Services are proposing to eliminate the inpatient-only list over the next three years. Medicare’s often-misunderstood inpatient-only list may soon be departing, as the Centers for…
Medicare outpatient payments are slated to increase by 2.6 percent next year, a $7.5 billion boost compared to 2020, according the proposed 2021 Outpatient Prospective Payment System (OPPS) rule. Released…
On July 20, the Office of Inspector General (OIG) released a report that found that hospitals are overbilling or upcoding hospitals to the tune of $1 billion. OIG reviewed 200…
The Trump Administration today announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of healthcare services from their doctors without having to travel to a…
CMS report is based on 2016-2017 data. It’s been two years since the American Hospital Association (AHA) shouted from the rooftops that documentation by any interprofessional team would be accepted…
CMS’s IMM sends mixed messages to providers. The Important Message from Medicare (IMM) has changed significantly in its latest reiteration, and the IMM now must be presented to both Medicare…
New Medicare office-visit coding guidelines take effect Jan. 1, 2021, and are designed to be more intuitive and make unnecessary documentation tasks go away. Experts believe the transition will be…
The owner of a transportation company has pleaded guilty to fraudulently billing millions in false claims to the state’s Medicaid Program (MassHealth), Attorney General Maura Healey announced today. Michael Davini,…