News & Analysis as of

MPFS Hospitals Physicians

Health Care Compliance Association (HCCA)

Compliance with Medicare’s updated 2024 split (or shared) visit policy

Split (or shared) visits—the current term used by the Center for Medicare & Medicaid Services (CMS)—allow non-physician practitioners (NPPs) and physicians who work for the same employer/entity to share patient visits on the...more

Health Care Compliance Association (HCCA)

Final Physician Rule Changes Supervision, Adds Telehealth Codes, Some Permanently

Report on Medicare Compliance 29, no. 43 (December 7, 2020) - In the 2021 final Medicare Physician Fee Schedule (MPFS) rule, CMS made both permanent and temporary changes to supervision, telehealth and other provisions,...more

Health Care Compliance Association (HCCA)

CMS Rules: Direct Supervision Is Gone, Prior Auth Is Here; Documentation Fix Has Limits

Report on Medicare Compliance 28, no. 40 (November 11, 2019) - CMS has given the green light to prior authorization for five types of procedures in an attempt to control “unnecessary increases” in these procedures as part...more

Bricker Graydon LLP

CMS announces continuation of second year of site-neutral payment cuts

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Despite a court ruling against its site-neutral policy in September 2019, in the Calendar Year (CY) 2020 Medicare Outpatient Prospective Payment System (OPPS) final rule, released on November 1, 2019, the Centers for Medicare...more

Holland & Knight LLP

CMS Releases the 2019 MPFS and QPP Final Rules

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• The Centers for Medicare & Medicaid Services (CMS) has published the Calendar Year (CY) 2019 Final Rule for the Medicare Physician Fee Schedule (PFS), which includes provisions related to Medicare physician payments as well...more

McGuireWoods LLP

2018 Reimbursement Cuts for Some Off-Campus Hospital Provider-Based Departments

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On Nov. 2, 2017, the Centers for Medicare and Medicaid Services (CMS) finalized a rule changing reimbursement rates under the Medicare Physician Fee Schedule (MPFS) for certain non-excepted hospital off-campus provider-based...more

Holland & Knight LLP

Top Takeaways for Medicare Physician and Hospital Payments in 2018

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The Centers for Medicare & Medicaid Services (CMS) on Nov. 1, 2017, released the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Medicare Ambulatory Surgical Center (ASC) Payment System Final Rule for...more

BakerHostetler

Provider-Based Status Post-BBA: CMS Offers Limited Answers, Requests More Feedback

BakerHostetler on

For those in the hospital industry hoping for additional clarity regarding the operation and billing of provider-based departments (PBDs), the CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule provides some...more

Dorsey & Whitney LLP

CMS Issues Proposed Rule Addressing Off-Campus Outpatient Departments

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The Centers for Medicare and Medicaid Services (CMS) published its 2017 Medicare Outpatient Prospective Payment System (OPPS) proposed rule on July 14, 2016 (the Proposed Rule). In part, the Proposed Rule addresses CMS’s...more

King & Spalding

CMS Proposes Changes to Provider-Based Status in CY 2017 OPPS Rule - Agency takes aggressive view of Section 603 of Bipartisan...

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On July 6, 2016, the Centers for Medicare & Medicaid Services (CMS) issued its CY 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule. The Proposed Rule includes several provisions regarding how CMS will...more

Stinson LLP

Reimbursement Change for Off-Campus Provider-Based Clinics, Physician Offices, and Ambulatory Surgical Centers

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On November 2, 2015, President Obama signed the Bipartisan Budget Act of 2015, a two-year budget deal with a key provision affecting hospitals and other health care providers. Effective January 1, 2017, the Act decreases the...more

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