Reimbursement and Payment Methodologies

Analyze the potential impact of CMS’ major proposed changes to physician reimbursement.

Learn about updates to the MIPS Value Pathways program and additional changes in the 2022 Medicare Physician Fee Schedule proposed rule.

Ensure your organization is in compliance with CMS’ latest requirements.

Take a look at the implications and compliance risks of the No Surprises Act.

CMS is rescinding audit determinations for off-campus provider-based departments that claimed the mid-build exception under the 21^st Century Cures Act,

CMS will begin reprocessing 2019 claims for some services rendered at excepted off-campus provider-based departments. The affected claims are for services represented by HCPCS code G0463 (hospital outpatient clinic visit for assessment and management of a patient) with dates of service between January 1, 2019, and December 31, 2019.

Successfully responding to payer charge audits for services billed above room and bed rate can be a challenge. The Cleveland Clinic contracting, compliance, and revenue cycle departments worked together on a project to address this focus. 

Speakers and registrants shared tips and insights into revenue integrity hot topics on day one of the 2021 Revenue Integrity Symposium, held virtually August 17–18.

CMS released the fiscal year (FY) 2022 IPPS final rule on Monday, August 2, which finalizes its efforts to cushion the ongoing impact of the COVID-19 pandemic on hospital revenue and resources. Along with payment rate updates, the final rule also repealed the MS-DRG relative weight methodology and hospital cost-reporting requirement finalized in the 2021 IPPS final rule.