By November 1, 2021, the U.S. Centers for Medicare & Medicaid Services (CMS) will begin reprocessing claims for outpatient clinic visit services provided at excepted off-campus Provider-Based Departments (PBDs) so they’re paid at the same rate as non-excepted off-campus PBDs for those services under the Medicare Physician Fee Schedule (PFS).

This affects certain claims with dates of service between January 1 and December 31, 2019. CMS will reprocess all affected claims. Providers will need to refund the coinsurance difference to patients (or payers) who paid the higher coinsurance rates based on new remittance advice information.

Source: U.S. Centers for Medicare & Medicaid Services (CMS)

 

About 3Gen

3Gen Consulting has always been in the forefront when it comes to adding value. We always believe in setting our own standards. What sets us apart is the investment that we make in our people, processes and innovation to provide you with market leading healthcare revenue cycle management services. We work as an extension of our clients’ teams by focusing on their key challenges, aligning with their culture and delivering the best results.

If you’re interested in finding the right medical billing and coding services partner, contact us today.

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