News & Analysis as of

HCPCS

Bricker & Eckler LLP

CMS to begin reprocessing hospital claims for 2019 clinic visits provided at excepted off-campus provider-based departments

Bricker & Eckler LLP on

Buried within the latest issue of the Centers for Medicare and Medicaid Services’ (CMS) MLN Connects, dated January 14, 2021, is an announcement from the agency that hospitals with excepted hospital outpatient departments...more

King & Spalding

CMS Proposes New DMEPOS Coverage Policies and Payment Rates, and Seeks to Codify HCPCS Application, Benefit Category and Payment...

King & Spalding on

On November 4, 2020, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule (the Proposed Rule) outlining proposals for the coverage and payment for durable medical equipment, prosthetics, orthotics, and...more

King & Spalding

CMS Releases Calendar Year 2021 Outpatient Prospective Payment System and Ambulatory Surgical Center Final Rule

King & Spalding on

On December 2, 2020, CMS issued the calendar year (CY) 2021 Medicare Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule. Through these policy changes, CMS seeks to...more

Foley & Lardner LLP

Top Five New Telehealth Policies in Medicare 2021 in Physician Fee Schedule

Foley & Lardner LLP on

The Centers for Medicare and Medicaid Services (CMS) just released its 2021 Final Rule (Physician Fee Schedule), with telehealth policy changes and a list of new services covered under Medicare. Actions taken by CMS during...more

Arent Fox

CMS Releases Interim Final Rule Establishing Reimbursement for Part B Drugs Based on International Pricing

Arent Fox on

Most Favored Nations Model will alter how certain Medicare Part B drugs are reimbursed. The Centers for Medicare & Medicaid Services (CMS) released an advance copy of an interim final rule with a comment period announcing...more

Foley & Lardner LLP

Federal Departments Release Transparency in Coverage Final Rule

Foley & Lardner LLP on

On October 29, 2020 the United States Departments of Health and Human Services, Labor and Treasury (the Departments) issued a final rule entitled Transparency in Coverage (the Rule). The Rule continues on the Trump...more

Ward and Smith, P.A.

Time for a Checkup: Recent Federal Efforts Regarding Telehealth - Part I

Ward and Smith, P.A. on

The public health emergency (PHE) for COVID-19 has brought about many changes to the way healthcare is practiced, delivered, and reimbursed. This article will discuss some of the major recent changes to telehealth on the...more

Arent Fox

HOPPS and Physician Fee Schedule Proposed Rules: What Pharmaceutical and Device Manufacturers Need to Know

Arent Fox on

CMS is soliciting comments on whether future payments for devices that may have been impacted by the COVID-19 PHE should be adjusted. The Centers for Medicare & Medicaid Services (CMS) issued its annual proposed rule related...more

King & Spalding

CMS Releases Proposed 2021 Physician Fee Schedule

King & Spalding on

On August 3, 2020, CMS issued a proposed rule which updates payment policies, payment rates, and other provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2021 (the...more

McDermott Will & Emery

CMS Takes a Preliminary Step to Make Certain COVID-19 Waivers Permanent

McDermott Will & Emery on

On August 4, 2020, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule to update its payment policies under the Medicare Physician Fee Schedule (PFS) for calendar year 2021. The proposed rule was...more

Bricker & Eckler LLP

D.C. Circuit upholds Medicare policy of paying hospital outpatient provider-based locations and physician offices the same,...

Bricker & Eckler LLP on

On July 17, 2020, the D.C. Circuit Court found that the Department of Health and Human Services’ (HHS) and the Centers for Medicare & Medicaid Services’ (CMS’) policy of paying grandfathered off-campus provider-based...more

Dentons

DC Circuit sides with CMS in lawsuit challenging site-neutral payment rule

Dentons on

On Friday, July 17, 2020, the US Court of Appeals for the District of Columbia Circuit reversed the district court to uphold a 2019 Medicare payment rule expanding outpatient “site-neutral” payment policies to apply to all...more

Bricker & Eckler LLP

Medicare to require prior authorization for certain outpatient department services starting July 1, 2020

Bricker & Eckler LLP on

In the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (2020 OPPS Final Rule), the Centers for Medicare and Medicaid Services (CMS) established a prior authorization process and...more

Health Care Compliance Association (HCCA)

CMS reveals new HCPCS code for coronavirus lab tests

Compliance Today (May 2020) - The Centers for Medicare & Medicaid Services (CMS) announced on March 6, 2020, in a special edition of MLN Connects[1] that the agency has taken “additional actions to ensure America’s...more

Burr & Forman

Coronavirus (COVID-19) Health Care Helpful Hints

Burr & Forman on

CMS CREATES NEW CODE FOR CORONAVIRUS TESTING. The Centers for Medicare & Medicaid Services (CMS) recently announced it has created a new Healthcare Common Procedure Coding System (HCPCS) code which healthcare providers and...more

Brownstein Hyatt Farber Schreck

Health Plan Coverage of Coronavirus Testing and Treatment

With the news about the spread of the 2019 novel coronavirus (“COVID-19”) in the U.S. and the world rapidly evolving, group health plan sponsors need to address how the plan will provide virus-related benefits. ...more

Holland & Knight LLP

CMS Issues New Medicare Reimbursement Guidance for Diagnosis and Treatment of Coronavirus

Holland & Knight LLP on

The Centers for Medicare and Medicaid Services (CMS) has issued new guidance for frequently asked questions related to Medicare reimbursement for items and services provided in connection with the diagnosis and treatment of...more

Arent Fox

CMS Issues A Second Billing Code for COVID-19 Testing

Arent Fox on

The Centers for Medicare and Medicaid Services (CMS) issued a second Healthcare Common Procedure Coding System (HCPCS) code to be used by laboratories for the testing and tracking of new cases of the 2019-Novel Coronavirus...more

Bricker & Eckler LLP

COVID-19 Update: Reimbursement issues – Who is picking up the tab for coronavirus testing?

Bricker & Eckler LLP on

Insurance coverage - In a statement on March 6, 2020, the Board of Directors for America’s Health Insurance Plans (AHIP) announced that insurers are voluntarily covering the diagnostic testing of COVID-19 (coronavirus)...more

Health Care Compliance Association (HCCA)

Report on Medicare Compliance Volume 29, Number 4. News Briefs: February 2020

Report on Medicare Compliance 29, no. 4 (February 3, 2020) - ? Central Coast Inpatient Consultants Inc. in California has agreed to pay $750,000 in a civil monetary penalty settlement with the HHS Office of Inspector...more

Dentons

CMS ignores district court ruling and proceeds with planned payment cuts for hospital outpatient clinic visits at off-campus...

Dentons on

In its hospital outpatient prospective payment system (OPPS) Final Rule for calendar year 2020, CMS finalized its proposal to implement the planned phase-in (already underway) of a site-neutral payment policy (i.e., payment...more

Bass, Berry & Sims PLC

CMS Proposal Vastly Expands Medicare Coverage for Opioid Treatment

Bass, Berry & Sims PLC on

On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) took the first steps toward welcoming opioid treatment programs (OTPs) into the Medicare program and expanding Medicare coverage of opioid use disorder...more

Husch Blackwell LLP

Hospitals React Strongly To CMS’ Changes To Hospital Outpatient Payments

Husch Blackwell LLP on

Hospitals are not happy with CMS’ recent changes to hospital outpatient payments. Two hospital associations and three hospitals claim in a federal lawsuit filed December 4, 2018, that CMS had no authority to change the...more

Baker Ober Health Law

CMS Adopts Important "Site-Neutral" Changes to Payment Rules

Baker Ober Health Law on

CMS took another step in its campaign to impose "site neutrality" on hospital outpatient payments with its recently published final Medicare hospital Outpatient Prospective Payment System (OPPS) rule for CY 2019. The final...more

Robinson+Cole Health Law Diagnosis

2019 Physician Fee Schedule Rule Review: CMS Recognizes “Virtual Check-Ins” and “Store and Forward” Remote Service Offerings

On November 1, 2018, the Centers for Medicare & Medicaid Services issued a final rule that updated payment policies and rates under the Medicare Physician Fee Schedule (PFS). This rule also formalized two types of remote...more

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JD Supra Privacy Policy

Updated: May 25, 2018:

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Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

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Privacy Officer
JD Supra, LLC
10 Liberty Ship Way, Suite 300
Sausalito, California 94965

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Updates to This Policy

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Contacting JD Supra

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