CMS proposes updates to the payment rates for Partial Hospitalization Programs (PHPs) and Intensive Outpatient Programs (IOPs) furnished in HOPDs and Community Mental Health Centers (CMHCs). The Proposed Rule includes revisions to the coding and billing requirements for PHP and IOP services to...
consistent in type, frequency and duration of treatment with scientifically based guidelines of national clinical, research, or health care coverage organizations or governmental agencies that are accepted by the Company; and D. consistent with the diagnosis of the condition; and E. ...
The proposed rule change does not spell out the criteria for billing for additional time, however. COA also suggested that the use of a time-based add-on code would place too much importance on the length of a visit, rather than the quality of MDM. “Providers should be abl...