Q: If an anesthesiologist performs a presurgical or postsurgical block for pain control and it is performed in a holding area rather than in the operating room (OR), can we bill a separate facility (technical) fee for that? Or would this be bundled with OR services?
CMS recently released new hospital price transparency sample formats. The formats, which come in wide, tall, and plain, may be used by hospitals to meet the requirement to make standard charges publicly available in a machine-readable file.
Q: How do we to handle charges for donor-related services when the donor is an unsuccessful match? Should the charges for services provided to a potential donor who is an unsuccessful match also be included on the transplant recipient claim or should they be adjusted and just included on the cost report?
CMS is weighing an expansion of the hospital outpatient department prior authorization program, changes to 340B reimbursement in the wake of the Supreme Court’s decision, and alternative rate setting data among other proposals in the 2023 Outpatient Prospective Payment System (OPPS) proposed rule.
