CMS makes changes to behavioral health, new codes, and cuts to rates in 2025 MPFS final rule

Wed, 11/06/2024
Revenue Integrity Insider
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, News, Reimbursement and Payment Methodologies, Revenue Integrity

Organizations must prepare for a slew of new codes and billing updates for Part B payment, according to the 2025 Medicare Physician Fee Schedule (MPFS) final rule. The final rule, released November 1, details CMS’ numerous changes to payment rates, billable services, telehealth rules, and other services.

CMS FY 2025 IPPS Final Rule Summary

Tue, 11/05/2024 - 11:33
White Papers
Billing and Claims, Coding and Documentation, Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

On August 1, 2024, the Centers for Medicare & Medicaid Services (CMS) issued the federal fiscal year (FFY) 2025 Medicare Hospital Inpatient Prospective Payment System (IPPS) final rule. Our government reimbursement experts did the heavy lifting for you and...

OIG: RPM requires more oversight from CMS

Wed, 10/16/2024
Revenue Integrity Insider
Billing and Claims, Compliance, Monitoring and Audits, News, Revenue Integrity

The Office of Inspector General (OIG) published a report on potential oversight vulnerabilities related to remote patient monitoring (RPM) in Medicare.

Download the October 2024 issue of the NAHRI Journal

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Denials and Appeals, Monitoring and Audits, Policies and Procedures, Program Management, Reimbursement and Payment Methodologies, Revenue Integrity

Set the stage for success and close out the year strong.

2025 IPPS final rule calls for a TEAM effort

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Learn how to ensure your organization is in compliance with CMS’ newest rules.

Putting the 2025 OPPS proposed rule under the microscope

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Take a closer look at major changes in the works for outpatient reimbursement.

Navigating the 2025 MPFS proposed rule

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Chargemaster and Charge Capture, Coding and Documentation, Compliance, Coverage, Reimbursement and Payment Methodologies, Revenue Integrity

Consider how CMS’ proposed changes could impact your organization.

MSSP overhaul

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Catch up on potential changes to the Medicare Shared Savings Program (MSSP).

Staying up to date with NCCI edits

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Billing and Claims, Coding and Documentation, Compliance, Monitoring and Audits, Policies and Procedures, Reimbursement and Payment Methodologies, Revenue Integrity

Review recent changes and compliance tips for NCCI edits.

DSH payments: Understanding compliance, payment, and opportunities

Wed, 10/02/2024
NAHRI Journal - Volume 8, Issue 4
Compliance, Reimbursement and Payment Methodologies, Revenue Integrity

Dig deeper into compliance and reimbursement issues for disproportionate share hospitals.

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