- Taking Action to Expand Access to Emergency Care Services in Rural Communities
- People with Disabilities: Help Address Disparities
News
Taking Action to Expand Access to Emergency Care Services in Rural Communities
On June 30, as part of the Biden-Harris Administration’s ongoing effort to strengthen rural health, CMS is releasing a new proposed rule protecting access to emergency care and additional outpatient services for people in rural communities. CMS is establishing the conditions of participation for rural emergency hospitals (REHs). The proposed rule will allow small rural hospitals to seek this new health care provider designation and provide continued access to emergency services, observation care, and additional medical and outpatient services. In accordance with the statutory legislation, REHs will be eligible to receive payment for services provided on or after January 1, 2023. This is a significant step in building on the Administration’s efforts to reduce health care disparities and maintain access to services in rural communities.
More Information:
People with Disabilities: Help Address Disparities
People living with disabilities are less likely to have access to adequate health care. They also face poorer overall health outcomes, including increased likelihood of obesity (38.2%), heart disease (11.5%), and diabetes (16.3%).
During the American Disabilities Act anniversary month, find out how you can help address these challenges.
More Information:
- Modernizing Health Care to Improve Physical Accessibility web-based training
- Achieving Health Equity web-based training
- Improving Access to Care for People with Disabilities webpage
- Health Equity Challenges & CMS Resources to Help Address Them (PDF) infographic
- CMS Office of Minority Health: Health Observances webpage
Compliance
DMEPOS Standard Written Order Requirements
Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) suppliers — follow requirements for standard written orders (SWOs):
- Keep an SWO from the treating practitioner on file
- Get the SWO before submitting a claim for all DMEPOS items
- Get the SWO before delivering certain items
- Submit completed SWOs for all DMEPOS services billed if there’s an audit
Review 42 CFR 410.38 and MLN Matters Article SE20007 (PDF) to learn what elements to include on the order and related documentation:
- Beneficiary name or Medicare beneficiary identifier
- General description of the item
- Quantity you’ll dispense, if applicable
- Order date
- Treating provider name or national provider identifier
- Treating provider signature
More Information:
- Standard Documentation Requirements for All Claims Submitted to DME Medicare Administrative Contractors (MACs) local coverage article
- Find SWO final rule FAQs on your MAC’s website: Noridian JA & JD, CGS JB & JC
Claims, Pricers, & Codes
Long COVID: Use ICD-10 Code U09.9
For a post COVID-19 condition, unspecified, like Long COVID, use code DX U09.9. Add other codes for conditions related to the COVID-19 infection, like R50.9 for fever.
For a current COVID-19 infection, use code DX U07.1. Don’t use code DX U09.9.
For a current COVID-19 infection and conditions from a previous COVID-19 infection, use code U09.9 with code DX U07.1. Add other codes for conditions related to the COVID-19 infection, like R06.02 for shortness of breath.
For more information, see pages 30-31 of ICD-10-CM Official Guidelines for Coding and Reporting: Fiscal Year 2022 (PDF).
MLN Matters® Articles
July 2022 Update of the Ambulatory Surgical Center (ASC) Payment System — Revised
Learn about revisions to remove HCPCS codes A9601 and J0739 (PDF).
Publications
Teaching Physicians, Interns, & Residents Guidelines — Revised
Learn about what's changed (PDF):
- Updated teaching settings to include any telehealth service or procedure through audio/video real-time technology
- Added content about interpreting diagnostic radiology and other tests if a physician other than a resident does the interpretation or review
- In residency training sites outside a metropolitan statistical area (MSA), teaching physicians, as required, may use audio/video real-time technology when the resident does services
- Added content about psychiatric services under an approved graduate medical education program, including documentation
- Medicare Part A pays graduate medical training programs separately when total time determines office or outpatient evaluation and management (E/M) visit level, which includes the resident’s time providing services with a teaching physician present
- When total time decides the office or outpatient E/M visit level, only include teaching physician-presence time
- After providing the service, you must document the medical record with the teaching physician’s physical or virtual presence, including telehealth services, only in residency training sites outside an MSA
- Starting January 1, 2022, teaching physicians may use only medical decision making when selecting E/M visit level for time-based office and or outpatient E/M visits under the primary care exception
- During the public health emergency (PHE), we expanded the residents’ services list
- After the PHE, we’ll no longer include levels 4–5 office or outpatient E/M visits in the primary care exception
- For all teaching settings during the PHE, teaching physicians may direct care and review services each resident provides during or at once after each visit through audio/video real-time technology
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