There is a modicum of good news in the final CY 2012 Physician Fee Schedule (PFS). CMS has decided to delay until July 1, 2012, implementation of the expanded scope of the three-day payment window to non-provider-based physician practices and clinics. The rule also provides a billing code to identify those services, so that payments to these physicians may be appropriately identified and reduced. CMS’s discussion of these changes can be found here (see full alert below for links)...
Background
Medicare has long required that most pre-admission services furnished prior to a beneficiary’s inpatient admission to a hospital be “bundled” into the hospital’s inpatient prospective payment (IPPS) rate if both (i) the entity furnishing the pre-admission services is wholly-owned or wholly-operated by the admitting hospital and (ii) the service is furnished within three days of the inpatient admission (or one day in the case of hospitals excluded from IPPS). The “bundled” services subject to the window include all pre-admission diagnostic services and most nondiagnostic services. The few services excluded are nondiagnostic services unrelated to the beneficiary’s inpatient admission, ambulance services, and maintenance renal dialysis services...
Please see full publication below for more information.
