Insights

CMS To Reprocess Certain Claims For Outpatient Clinic Visit Services

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 ...

AMA Releases 2022 CPT Code Set

The American Medical Association (AMA) released updates to the Current Procedural Terminology (CPT) code set for 2022. The new code set aims to streamline reporting and tracking of COVID-19 reporting, among other updates. ...

CMS Expands Medicare Payments for At-Home COVID-19 Vaccinations

In an effort to increase access to COVID-19 vaccinations, the Centers for Medicare & Medicaid Services (CMS) is expanding opportunities for people to receive vaccinations at home. Healthcare providers can now receive additional payments for administering vaccines to multiple residents ...

Medicare Reimbursement Announced For Third Dose Of COVID-19 Vaccine For Immunocompromised Individuals

The U.S. Food and Drug Administration (FDA) amended the emergency use authorizations for both the Pfizer-BioNTech and the Moderna COVID-19 vaccines to allow for the use of an additional dose in certain immunocompromised individuals, especially solid organ transplant recipients or ...

Hospital Inpatient Prospective Payment System & Long-Term Care Hospital Prospective Payment System For Fiscal Year 2022

The Centers for Medicare & Medicaid Services (CMS) has issued the final rule for fiscal year (FY) 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS). The rule revises the Medicare IPPS ...

Inpatient Psychiatric Facility Prospective Payment System Final Rule For Fiscal Year 2022

The Centers for Medicare & Medicaid Services (CMS) has issued a final rule that updates Medicare payment policies and rates for the Inpatient Psychiatric Facility (IPF) Prospective Payment System (PPS) for Fiscal Year (FY) 2022 and finalizes changes to the ...

Inpatient Rehabilitation Facility Prospective Payment System Final Rule For Fiscal Year 2022

The Centers for Medicare & Medicaid Services (CMS) has issued a fiscal year (FY) 2022 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) final rule, which updates Medicare payment policies and rates for IRFs, finalizes policies under the IRF Quality ...

Hospice Payment Rate Update Final Rule For Fiscal Year 2022

The Centers for Medicare & Medicaid Services (CMS) issued a final rule that updates Medicare hospice payments and the aggregate cap amount for fiscal year (FY) 2022, in accordance with existing statutory and regulatory requirements. This rule rebases the hospice ...

Skilled Nursing Facility Prospective Payment System Final Rule For Fiscal Year 2022

According to the Centers for Medicare & Medicaid Services (CMS) Skilled Nursing Facility (SNFs) Prospective Payment System (PPS) final rule for Fiscal Year (FY) 2022, SNFs will see an increase in Medicare Part A payments of approximately $410 million in ...
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