The 2021 Medicare Physician Fee Schedule (MPFS) final rule, released December 2, extends certain telehealth benefits but makes cuts to the Medicare conversion factor (CF) to offset evaluation and management (E/M) changes that would otherwise have resulted in significant reimbursement increases. Most provisions of the final rule are effective January 1, 2021.
United Healthcare (UHC) recently announced that it is delaying the implementation date of its unique laboratory code policy. The policy, which was originally set to go into effect January 1, 2021, will be delayed until January 1, 2022.
CMS announced on November 25 that it is building on the flexibilities granted by the Hospitals Without Walls program to launch the Acute Hospital Care at Home program. Under this program, eligible hospitals will be allowed to treat certain inpatients in the patient’s home.
The New COVID-19 Treatments Add-on Payment will allow additional Medicare payment for eligible hospital inpatient and outpatient cases that involve certain new products or treatments authorized or approved for COVID-19.
The American Medical Association (AMA) recently announced a handful of new CPT® codes for reporting COVID-19 vaccine products and immunization administration. The code release includes two vaccine product codes and four vaccine administration codes.
CMS provided clarification on submitting inpatient claims for patients diagnosed with novel coronavirus (COVID-19) without a positive viral test, in an update to MLN Matters SE20015 released September 11.
CMS extended the education and operations testing period for the Appropriate Use Criteria (AUC) program for advanced diagnostic imaging through 2021. The education and operations testing period, which started January 1, 2020, was slated to close at the end of the year. Payment penalties were scheduled to go into effect January 1, 2021.
The AMA on August 10 announced four new CPT® codes for reporting COVID-19 laboratory testing, including two codes for reporting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody detection.
CMS’ latest round of updates to its novel coronavirus FAQs on Medicare fee-for-service billing provides additional information on hospital billing for remote services, including a decision tree guiding hospitals through their options for billing for telemedicine.