CMS is considering a significant change to how it pays for certain high-cost radiopharmaceuticals, as well as a sweeping new set of Conditions of Participation (CoPs) aimed at maternal health, and a slew of other changes in the 2025 Outpatient Prospective Payment System (OPPS) proposed rule.
Organizations could see a flood of new codes along with significant changes to the Medicare Shared Savings Program (MSSP) and coverage of telehealth services, according the 2025 Medicare Physician Fee Schedule (MPFS) proposed rule.
This sample policy was provided to the National Association of Healthcare Revenue Integrity (NAHRI) by Erin Brearley Cutter, MBA, CHRI, CRCR, COC, CPC, revenue integrity director at Concord Hospital Health System in New Hampshire.
Get deep insights and analysis of the latest revenue integrity trends, chargemaster maintenance strategies, setting program priorities, and more during NAHRI’s free 2024 State of the Revenue Integrity Industry webinar today, June 5, 1–2 p.m. Eastern.
These sample guidelines for revenue reconciliation leadership reporting audits were submitted by 2024 NAHRI Leadership Council member Brittanie Smiddy, A.S., CPC, CHRI,
CRCR, Revenue Integrity Supervisor at Confluence Health in Washington.
