Thursday, April 16, 2020
- Hospice Payment Rate Update Proposed Rule for FY 2021
- IPF Prospective Payment System Proposed Rule for FY 2021
- SNF Proposed Payment and Policy Changes for FY 2021
- April 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS)
- Quarterly Update to the Fiscal Year 2020 Inpatient Psychiatric Facilities Pricer
- Claim Status Category and Claim Status Codes Update — Revised
- Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment — Revised
- Inpatient Rehabilitation Facility Prospective Payment System — Revised
- Medicare Overpayments — Revised
- Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services— Revised
- Medicare Fraud & Abuse: Prevent, Detect, and Report Web-Based Training Course — Revised
- Medicare Part C and Part D Data Validation Web-Based Training Course — Revised
View this edition as PDF (PDF)
News
Hospice Payment Rate Update Proposed Rule for FY 2021
On April 10, CMS issued a proposed rule (CMS-1733-P) that would update FY 2021 Medicare payment rates and the wage index for hospices serving Medicare beneficiaries. This rule provides model examples of the hospice election statement and the hospice election statement addendum that reflect the changes finalized in the FY 2020 hospice final rule for elections on or after October 1, 2020.
For More Information:
- Fact Sheet
- Proposed Rule : Submit comments by June 9
IPF Prospective Payment System Proposed Rule for FY 2021
On April 10, CMS issued a proposed rule (CMS-1731-P) for FY 2021 that updates the Medicare payment rates for Inpatient Psychiatric Facilities (IPFs). This proposed rule is part of our continuing efforts to strengthen the Medicare program by better aligning payment rates for these facilities with the costs of providing care.
For More Information:
- Fact Sheet
- Proposed Rule: Submit comments by June 9
SNF Proposed Payment and Policy Changes for FY 2021
On April 10, CMS issued a proposed rule [CMS-1737-P] for FY 2021 that updates the Medicare payment rates and the quality programs for Skilled Nursing Facilities (SNFs). This proposed rule is part of our continuing efforts to strengthen the Medicare program by better aligning payment rates for these facilities with the costs of providing care and increasing transparency so that patients are able to make informed choices.
For More Information:
- Fact Sheet
- Proposed Rule: Submit comments by June 9
Events
Ground Ambulance Organizations: Data Collection for Medicare Providers Call — May 7
Thursday, May 7 from 2 to 3 pm ET
Register for Medicare Learning Network events.
During this call, learn how to allocate costs, collect data, and report data for the new Ground Ambulance Data Collection System.
A question and answer session follows the presentation; however, you may email questions in advance to with “May 7 Call” in the subject line. These questions may be addressed during the call or used for other materials following the call. For more information, including ground ambulance organizations selected for the first round of reporting, see the Ambulances Services Center webpage, CY 2020 Physician Fee Schedule final rule, and Bipartisan Budget Act of 2018.
Target Audience: Ground ambulance organizations that are Medicare providers, including hospitals, critical access hospitals, skilled nursing facilities, home health agencies, comprehensive outpatient rehabilitation facilities, and hospices.
MLN Matters® Articles
April 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS)
A new MLN Matters Article MM11691 on April 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) (PDF) is available. Learn about changes to payment policies and billing instructions.
Quarterly Update to the Fiscal Year 2020 Inpatient Psychiatric Facilities Pricer
A new MLN Matters Article MM11759 on Quarterly Update to the Fiscal Year 2020 Inpatient Psychiatric Facilities Pricer (PDF) is available. Learn about updates to the comorbidity tables.
Claim Status Category and Claim Status Codes Update — Revised
A revised MLN Matters Article MM11467 on Claim Status Category and Claim Status Codes Update (PDF) is available. Learn about updated uniform resource locator references.
Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment — Revised
A revised MLN Matters Article MM11681 on Quarterly Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment (PDF) is available. Learn about new COVID-19 test codes.
Publications
Inpatient Rehabilitation Facility Prospective Payment System — Revised
A revised Inpatient Rehabilitation Facility Prospective Payment System Medicare Learning Network Booklet is available. Learn about:
- Payment rates
- Fiscal year updates
- Quality reporting program
Medicare Overpayments — Revise
A revised Medicare Overpayments Medicare Learning Network Fact Sheet is available. Learn about:
- Definition of an overpayment
- Collection tools and processes
- Payment options
Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services— Revised
A revised Screening, Brief Intervention, and Referral to Treatment (SBIRT) Services Medicare Learning Network Booklet is available. Learn about:
- Covered Services
- Medicare and Medicaid eligible providers
- How to bill for dual eligibles
Multimedia
Medicare Fraud & Abuse: Prevent, Detect, and Report Web-Based Training Course — Revised
With Continuing Education Credit
A revised Medicare Fraud & Abuse: Prevent, Detect, and Report Web-Based Training (WBT) course is available through the Medicare Learning Network Learning Management System. Learn about:
- Identifying fraud and abuse
- Provisions and penalties
- Prevention methods
- Reporting
Medicare Part C and Part D Data Validation Web-Based Training Course — Revised
A revised Medicare Part C and Part D Data Validation Web-Based Training (WBT) course is available through the Medicare Learning Network Learning Management System. Learn about:
- Planning and performing
- Analyzing results
- Completing post-data validation activities
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