ASC Billing Challenges continue to evolve as CMS’s 2025 policies introduce new guidelines for outpatient reimbursement. Ambulatory Surgery Centers (ASCs) must navigate regulatory updates, reimbursement modifications, and compliance requirements to ensure financial stability. Understanding these challenges and ...
The article examines the clinic and emergency department visit billing under hospital outpatient prospective payment guidance of the Centers for Medicare and Medicaid Services in the U.S. A summary of the guidance regarding the flexibility to create internal guidelines that will capture usage of ...
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 ...
The Final Rule includes the scope of benefits, physician certification requirements, coding and billing guidelines, and payment rates under the IOP benefit. CMS finalized its proposal that IOP services may be furnished in hospital outpatient departments, community mental health centers, federally ...
will go into effect on Oct. 1, 2020. In the interim, between July 1 and October 1, a temporary C-code (C9061) has been established for TEPEZZA to support Medicare Fee-for-Service pass-through payment in the hospital outpati...
1However, current coding and payment structure for E/M office and outpatient visits will continue for CY 2019 and CY 2020. “For CYs 2019 and 2020, we are implementing several documentation policies to provide immediate burden reduction, while other changes to documentation, coding...