Q: We have patients that come to the emergency department (ED), are seen by a physician assistant, nurse practitioner, doctor of osteopathic medicine, or medical doctor, have tests ordered, then leave before the tests results are given to the patient. Can the facility charge an ED visit or not...Read More »
CMS' administratorurged hospitals to go above and beyond the price transparency requirements laid out in the 2019 IPPS final rule. The requirement that hospitals post a list of their standard charges online in a machine-readable format went into effect January 1.Read More »
CMS released additional instructions to the Medicare Claims Processing Manual for the accurate interpretation of claim edits and assignment of modifiers -59 and -91 on Medicare Part B claims.Read More »
Hospital stakeholders "immeasurably pleased" with the court's "carefully reasoned decision." HHS says the ruling could harm funding for other vital healthcare programs.Read More »
Hospitals are allowed to publish a list of charges that contains UB-04 revenue codes when complying with 2019 IPPS final rule requirements requiring the publication of standard charges, the American Hospital Association (AHA) said in a ...Read More »
A proposed rule that would expand the use of prior authorization and step therapy for Part D and Medicare Advantage beneficiaries has earned criticism from patient advocacy groups and praise from pharmacy groups.Read More »