CMS adjusted payments under OPPS and Inpatient Prospective Payment System (IPPS) to include the additional costs of domestically manufactured, National Institute for Occupational Safety and Health (NIOSH)-approved surgical N95 respirators, effective Jan. 1, 2023. CMS will categorize all ...
CMS proposes to add three services to the inpatient-only list, which includes services that should only be performed inpatient due to their complexity and the level of post-operative care required (CPT codes 0894T, 0895T and 0896T). Partial Hospitalization Services CMS proposes updates to t...
Source: “Table 65: Changes to the inpatient only (IPO) list for CY 2023” fromCMS’ CY2023 Medicare Hospital OPPS and ASC Payment System Final Rule How is ASC covered procedures list (CPL) changing in 2023? CMS is also adding four procedures...
Inpatient Only List The IPO list was established in rulemaking as part of the initial implementation of the OPPS; the list identifies services for which Medicare will make payment only when such services are furnished in the inpatient hospital setting.7In CY 20...
CMS itself proposed five new codes to be added to the Medicare Telehealth Services list on a permanent basis: G0316 (Prolonged hospital inpatient or observation care evaluation and management service(s) beyond the total time for the primary service (when the primary service has been selected using...
By regulation, CMS currently permits restatements to be made outside of the 12-quarter window only in certain circumstances, including based on “internal investigations.” In the proposed rule, CMS sought to narrow this exception by limiting “internal investigations...
He also suggested changing requirements within the inpatient prospective payment system, an annual Medicare rule. Hospitals are financially dinged when patients have to readmit to the facility within 30 days of a discharge, but Mango advocates for rewarding positive outcomes—like evaluating whether a ...
CMS declined to define the term “sold” as it applies to the definition of “market date” and stated that manufacturers may use reasonable assumptions as to the date a sale has occurred. Notably, in response to a comment that a sale only occurs if the ...