Thursday, November 11, 2021
- Provider Enrollment Application Fee for CY 2022
- LTCH & IRF: CY 2022 QRP Updates
- Critical Care E/M Services: Comparative Billing Report in November
- Diabetes Resources for You & Your Patients
News
Provider Enrollment Application Fee for CY 2022
On October 25, CMS issued a notice in the Federal Register establishing the Calendar Year (CY) 2022 provider enrollment application fee. Effective January 1 – December 31, 2022, the application fee is $631 for institutional providers (as defined in 42 CFR § 424.502) who are:
- Initially enrolling in the Medicare or Medicaid programs or the Children's Health Insurance Program (CHIP)
- Revalidating their Medicare, Medicaid, or CHIP enrollment
- Adding a new Medicare practice location
You must pay this fee when you submit any of these enrollment applications in CY 2022.
LTCH & IRF: CY 2022 QRP Updates
On November 2, CMS issued a Calendar Year (CY) 2022 Home Health(HH) final payment rule that updated the Long-Term Care Hospital Quality Reporting Program (LTCH QRP). These updates include:
- A change in the compliance date for collecting the Transfer of Health Information to Provider-Post-Acute Care (PAC) Quality measure data
- The Transfer of Health Information to Patient-PAC Quality measure
- Certain standardized patient assessment data elements to begin October 1, 2022
Critical Care E/M Services: Comparative Billing Report in November
In late November, CMS will issue a third educational letter in the Special Edition Comparative Billing Report (CBR) series on Part B claims for Critical Care Evaluation and Management (E/M) Services. Use the data-driven tables to compare your billing and payment patterns with peers in your state and across the nation.
CBRs aren’t publicly available. Look for an email from cbrpepper.noreply@religroupinc.com to access your report. Update your email address in the Provider Enrollment, Chain, and Ownership System to ensure delivery.
For More Information:
- View a webinar recording
- Visit the CBR website
- Register for a live webinar (December 1 from 3 – 4 pm ET)
Diabetes Resources for You & Your Patients
Medicare covers these preventive services to detect and treat diabetes:
- Diabetes screenings
- Diabetes self-management training
- Diabetes Prevention Program
- Nutrition therapy services
New diabetes cases have increased among non-Hispanic Blacks and existing cases are highest among American Indian and Alaska Native people.
Use these resources and talk to your patients about their risk factors during National Diabetes Month:
- Medicare Diabetes Prevention & Diabetes Self-Management Training (PDF) fact sheet
- Medicare Diabetes Prevention Program Expanded Model (PDF) booklet
- National Diabetes Month webpage
- CMS Office of Minority Health: Health Observances webpage
Compliance
DMEPOS: Bill Correctly for Items Provided During Inpatient Stays
An Office of Inspector General (OIG) report determined that Medicare improperly paid suppliers for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) items provided during inpatient stays. Review the Medicare DMEPOS Improper Inpatient Payments (PDF) fact sheet to help you bill correctly.
More Information:
- Medicare Quarterly Provider Compliance Newsletter, Volume 9, Issue 2
- Medicare Claims Processing Manual, Chapter 20 (PDF), Section 10
- Medicare Claims Processing Manual, Chapter 30 (PDF), Section 130.1
- Medicare Inappropriately Paid Acute-Care Hospitals for Outpatient Services They Provided to Beneficiaries Who Were Inpatients of Other Facilities OIG Report
- Medicare Paid New England Providers Twice for Nonphysician Outpatient Services Provided Shortly Before or During Inpatient Stays OIG Report
- Medicare Continues to Pay Twice for Nonphysician Outpatient Services Provided Shortly Before or During an Inpatient Stay OIG Report
Claims, Pricers, & Codes
HCPCS Application Summaries & Coding Decisions: 510(k)-Cleared Wound Care Products
CMS published the 2021 HCPCS Application Summary for Supplemental Coding Cycle (PDF). Visit the HCPCS Level II Coding Decisions webpage for more information.
Events
HCPCS Public Meeting — December 1 & 2
Wednesday, December 1 and Thursday, December 2 from 9 am – 5 pm ET
Attend a virtual public meeting for the second 2021 biannual HCPCS coding cycle. Visit the HCPCS Public Meetings webpage for more information. View the meeting materials:
MLN Matters® Articles
Medicare Part B CLFS: Revised Information for Laboratories on Collecting & Reporting Data for the Private Payor Rate-Based Payment System
Learn about data reporting period changes for clinical diagnostic laboratory tests (CDLTs) (PDF) that aren’t advanced diagnostic laboratory tests:
- The next reporting period is delayed by one year to January 1 – March 31, 2022
- There’s a 3-year cycle after the next reporting period
- The payment reduction phase-in is extended through calendar year 2024
CMS developed an online data collection system to help laboratories submit data by March 31, 2022. We’ll post a revised user guide before the start of the upcoming data reporting period.
Like the newsletter? Have suggestions? Please let us know!
Subscribe to the MLN Connects® newsletter. Previous issues are available in the archive.
This newsletter is current as of the issue date. View the complete disclaimer.
Follow the MLN on Twitter #CMSMLN, and visit us on YouTube.
The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health and Human Services (HHS).
