The Centers for Medicare & Medicaid Services (CMS) finalized its Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) payment rates on Nov. 2 for calendar year (CY) 2024. TheFinal Rulewill be effective on Jan. 1, 2024. The Final Rule updates Medicare pay...
What's more, CMS is actively finalizing a new method for adjustments to mitigate the effects of "significant, anomalous and highly suspect" billing activity in CY 2024 and subsequent years on annual ACO financial reconciliation. In reaction to the final rule, the National Association of...
CMS released the Medicare Physician Fee Schedule (MPFS) Proposed Rule for calendar year (CY) 2024.
Notable CY 2024 Medicare PFS Proposals: Decrease the conversion factor by 3.34% to $32.75. Delay of the implementation of a split (or shared) visit based on time spent by the billing practitioner until at least January 1, 2025. Creation of new benefit categories for behavioral health ser...
The CMS final rule creates requirements for certain payers to streamline the prior authorization process. The rule also complements the Medicare Advantage requirements finalized in the Contract Year (CY) 2024 MA and Part D final rule, which add continuity of care requirements and reduce ...
•ByHannah Daniel The Medicare Physician Fee Schedule Final Rule for CY 2023 extended the coverage of telehealth services for 2023. • Source: Shutterstock The Centers for Medicare & Medicaid Services released its Physician Fee Schedule (PFS) for 2023 which extends coverage for some telehealth se...
Payment rates for the CY 2025 OPPS/ASC final rule were based on claims with dates of service between January 1, 2023, and December 31, 2023, processed through June 30, 2024, and is better reflective of the value CCTA provides in cardiac care. In addition, CCTA prominence has increased ...
rule would revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for Calendar Year (CY) 2023 based on CMS’ continuing experience with these systems. In this proposed rule, CMS describes the changes to the amo...
2024.In this 2024 proposed rule, CMS proposed a more limited set of changes to the MSSP that (according to CMS) are intended to be, “incremental refinements to the broader changes finalized in the CY 2023 PFS final rule.”Proposed changes for 2024 include: establishing a new Medicare ...
policies for the calendar year (CY) 2025 Home Health prospective payment system (PPS). CMS estimates a 2.7% increase, but when combined with the behavioral offset and other payment changes in the rule, the update will be a 0.5% increase — approximately $85 million — compared to CY 2024....