CMS

2025 MPFS final rule contains 2.93% reduction to overall payments

By ACDIS for CDI Strategies The 2025 Medicare Physician Fee Schedule (MPFS) final rule was released on November 1 and contains a number of billing modifications to payment rates, services, telehealth rules, and other such services. According to the National Association of Healthcare Revenue Integrity (NAHRI), CMS finalized a 2.83% reduction to the conversion factor.…

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CMS penalizes 2,499 hospitals for high readmissions: 5 things to know

By Ayla Ellison for Becker’s Hospital Review In fiscal year 2022, CMS will penalize 2,499 hospitals for having too many Medicare patients readmitted within 30 days, according to federal data analyzed by Kaiser Health News. This is the 10th year of the Hospital Readmissions Reduction Program. To determine penalties for fiscal year 2022, CMS used patient…

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CMS releases 4 final payment rules: 16 things to know

By Alia Paavola for Becker’s Hospital Review CMS on July 29 released its annual final payment rules for hospices, inpatient psychiatric facilities, inpatient rehabilitation facilities and skilled nursing facilities. Sixteen things to know about the rules: Hospices Under the final rule, hospices will see a 2 percent increase in payments for fiscal year 2022, compared…

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How CMS final rule will impact E/M coding and documentation requirements

By Ben Howard for Med City News This year ushered in many changes affecting reimbursement for healthcare providers, but few are as important as the new Physician Fee Schedule from the Centers for Medicare & Medicaid Services (CMS) and the updated coding guidelines for Evaluation and Management (E/M) services from the American Medical Association. For…

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10 changes CMS made in 2021

By Eric Oliver for Becker’s Hospital Review With the new calendar year, several CMS changes took effect, with more on the way. Here’s a roundup of changes CMS made or will make in 2021: Removed 298 musculoskeletal-related services. By 2024, all 1,700 procedures on the inpatient-only list will be phased out, and will be allowed…

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CMS releases FY 2021 ICD-10-PCS code set and official guidelines

By Revenue Cycle Advisor CMS recently released the fiscal year (FY) 2021 ICD-10-PCS code set, which includes 544 new codes for Fragmentations of the veins and arteries, Drainages of the pelvic cavity, and Imaging of various organs. It also released the FY 2021 ICD-10-PCS Official Guidelines for Coding and Reporting. The new ICD-10-PCS code set take effect…

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CMS relaxes more rules around telehealth, allowing care across state lines

By Mike Miliard for HealthcareIT News The Centers for Medicare and Medicaid Services has temporarily suspended several regulations to enable hospitals, clinics and other providers to boost their front-line medical staff during the coronavirus pandemic. The CMS changes reduce certification requirements for clinicians, with the aim of expanding workforce flexibilities and enabling practitioners to be…

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Top 5 revenue cycle management stories of 2019

By Ayla Ellison for Becker’s Hospital Review Physician specialties that generate the most revenue for hospitals and Medicare payment rules were among the healthcare revenue cycle management topics that piqued the interest of readers this year. Here are the five most popular revenue cycle management stories published by Becker’s Hospital Review in 2019: 1. These…

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CMS will pay $1.9 billion to hospitals in value-based payments for inpatient care

Susan Morse for Healthcare Finance Hospitals will receive $1.9 billion in value-based incentive payments for inpatient care, the Centers for Medicare and Medicaid Services announced yesterday. More hospitals will receive positive payment adjustments in 2020 than negative, CMS said. More than 1,500 hospitals (over 55%) will receive higher Medicare payments under the Hospital Value-Based Purchasing…

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