Skip to Main Content

Physician Center

Spotlights
  • Additional Clarification of Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions
    On August 19, 2013, in the FY2014 IPPS/LTCH final rule CMS clarified and revised the conditions of payment for hospital inpatient services under Medicare Part A related to patient status. On September 5, 2013, CMS released guidance that discussed the provisions of the final rule regarding the physician order and physician certification of hospital inpatient services. This document includes further clarification of issues addressed in the previous guidance.
  • Prior Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions
    The guidance provided in this document has been further clarified in Additional Clarification of Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions. This version of the guidance document will remain online for comparison purposes.
  • CMS-1600-FC: Revisions to Payment Policies under the Physician Fee Schedule, Clinical Laboratory Fee Schedule and Other Revisions to Part B for CY 2014.
  • Physician Groups of 100 or More: The Registration Period to Avoid a -1% Payment Adjustment Extended to Friday, October 18 - The Physician Value-Physician Quality Reporting System (PV-PQRS) Registration System is open through October 18, 2013. Representatives of group practices can select their group’s PQRS reporting mechanism for CY 2013, and groups with 100 or more eligible professionals (EPs), can elect quality tiering to calculate the Value Modifier for CY 2015.
  • The PV-PQRS Registration System can be accessed at https://portal.cms.gov using a valid IACS User ID and password. For additional information regarding registration and obtaining or modifying an IACS account, please see the Quick Reference Guide on the Self Nomination/Registration web page.

  • New Materials Available for Hospital Outpatient Prospective Payment System Proposed Rule
    CMS has posted corrected addenda, cost statistics files, an impact file, and an impact table for the CY 2014 Hospital Outpatient Prospective Payment System (OPPS) Proposed Rule (CMS-1601-P). These corrected files are available on the Hospital Outpatient PPS website. More information about the proposed rule is available on the Hospital Outpatient Regulations and Notices web page.
  • Frequently Asked Questions Regarding Change Request 7631 (Transmittal 2679)--Revised and Clarified Place of Service (POS) Coding Instructions.
  • Revised Fact Sheet for Referral Agents - Where are the Round 2 areas? What if a beneficiary travels? What do you need to know before prescribing a DMEPOS item or referring the beneficiary to a DMEPOS supplier? Want more information on the national mail-order program for diabetic testing supplies?

    For answers to these questions and more, see the revised “Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program: Referral Agents” Fact Sheet (ICN 900927), which is now available in downloadable format.

  • President Obama Signs the American Taxpayer Relief Act of 2012--New Law Includes Physician Update Fix through December 2013

    On Wednesday, January 2, 2013, President Obama signed into law the American Taxpayer Relief Act of 2012. This new law prevents a scheduled payment cut for physicians and other practitioners who treat Medicare patients from taking effect on January 1, 2013. The new law provides for a zero percent update for such services through December 31, 2013. This provision guarantees seniors have continued access to their doctors by fixing the Sustainable Growth Rate (SGR) through the end of 2013. President Obama remains committed to a permanent solution to eliminating the SGR reductions that result from the existing statutory methodology. The Administration will continue to work with Congress to achieve this goal. For more information, see January 2 Medicare FFS Provider e-News.

  • CMS-1590-FC: Revisions to Payment Policies Under the Physician Fee Schedule, DME Face to Face Encounters, Elimination of the Requirement for Termination of Non-Random Prepayment Complex Medical Review and Other Revisions to Part B for CY 2013. (Published: 11/16/2012)
  • Primary Care Incentive Program Payments for 2011 (posted 05/22/2012)
  • Blood Clotting Factor Furnishing Fee
  • Medicare FFS Physician Feedback Program/Value-Based Payment Modifier
  • The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the posting of updated educational materials on Section 6407 of the Affordable Care Act of 2010, which established a face-to-face encounter requirement for certification of eligibility for Medicare home health services. See the "Home Health Face-to-Face" part of the Spotlights section on Home Health Agency (HHA) Center web page.

MLN Connects Provider eNews Spotlights

  • Subscribe now to receive the weekly MLN Connects Provider eNews for the latest Fee-For-Service program information, event announcements, claims and pricer information, and MLN educational product updates.

Important Links

Billing / Payment

Enrollment/ Participation/ Certification

Policies/Regulations/Legislation

Education

Coverage

Coding

CMS Manuals & Transmittals

Accountable Care Organizations Workshop

Value-Based Purchasing Information

Forms

Medicare Prescription Drug Coverage

National Provider Identifier

Cost Reporting

Specialty Web Pages

Medicare Secondary Payer

Fraud & Abuse

Specialty Hospitals

Initiatives

Contacts

How to Stay Informed