CMS moved ahead with significant expansions to its site neutral payment policies, including reductions to payments for certain services at expected off-campus provider based departments (PBD), additional price transparency requirements, changes to its methodology for setting MS-DRG rates, and more, according to the 2026 Outpatient Prospective Payment System (OPPS) final rule.
After receiving negative feedback from industry stakeholders on its new reimbursement approach for certain inpatient Medicare Advantage (MA) claims, Aetna recently extended the policy’s implementation date.
Listening to a NAHRI Quarterly Call (free for NAHRI members) qualifies for one CHRI CEU credit upon the completion of the accompanying survey. If you’re a NAHRI member and are interested in presenting on an upcoming NAHRI members-only call, please contact NAHRI at...
Part B reimbursement is set for significant changes starting January 1, 2026, according to the 2026 Medicare Physician Fee Schedule (MPFS) final rule, released October 31. The final rule includes numerous major changes to how CMS will calculate reimbursement, updates to telehealth services, and much more.
CMS directed Medicare Administrative Contractors (MAC) to lift the claims processing hold issued earlier this month for certain services impacted by the government shutdown.
Medicare could have saved over $300 million if bundled payments for opioid use disorder (OUD) treatments more accurately reflected the services provided, according to a recent Office of Inspector General (OIG) audit report.
On October 1, Medicare telehealth policy reverted to its pre-COVID-19 PHE state. Several members of the NAHRI Advisory Board shared how their organizations are currently managing Medicare telehealth claims.
