Wednesday, November 23, 2022
- Colorectal Cancer Screening Test: Reduced Coinsurance for Related Procedures Begins January 1
- Ambulance Fee Schedule: CY 2023 Inflation Factor & Productivity Adjustment
- Medicare Ground Ambulance Data Collection System: Information to Help You Report
- Health Professional Shortage Area: CY 2023 Bonus Payments
- Rural Health: Help Address Disparities
- ESRD & Acute Kidney Injury Dialysis: CY 2023 Updates
- Home Health Prospective Payment System: CY 2023 Update
- Medicare Physician Fee Schedule Final Rule Summary: CY 2023
News
Colorectal Cancer Screening Test: Reduced Coinsurance for Related Procedures Begins January 1
Currently, planned colorectal cancer screening tests are free. However, if you add a procedure in the same clinical encounter as a result of the colorectal cancer screening, the patient pays a coinsurance.
Beginning January 1, 2023, CMS will gradually reduce coinsurance for procedures performed:
- In connection with a colorectal cancer screening test
- As a result of a screening test
- In the same clinical encounter as the screening test
The reduced coinsurance applies regardless of the code you bill.
For dates of service in CYs:
- 2023–2026, coinsurance is 15%
- 2027–2029, coinsurance is 10%
- Beginning 2030, no coinsurance
Learn more about phasing out coinsurance (PDF).
Ambulance Fee Schedule: CY 2023 Inflation Factor & Productivity Adjustment
The CY 2023 Ambulance Inflation Factor is 8.7%. For more information, see the instruction to your Medicare Administrative Contractor (PDF).
Medicare Ground Ambulance Data Collection System: Information to Help You Report
Get the latest information on the Medicare Ground Ambulance Data Collection System (GADCS). Starting January 1, selected ground ambulance organizations in Year 1 and Year 2 may report data through the GADCS portal. Other highlights include:
- New GADCS User Guide (PDF) that walks you through the portal.
- Lists of Year 3 (ZIP) and Year 4 (ZIP) ground ambulance organizations required to collect data starting in 2023 and report data starting in 2024. Medicare Administrative Contractors will email and send a letter to these organizations starting in December 2022.
- Revised Medicare Ground Ambulance Data Collection Instrument (PDF), including changes finalized in the CY 2023 Physician Fee Schedule final rule.
- Facilities (ZIP) and Vehicles (ZIP) templates revised after the August 4, 2022, webinar.
- Copy of Hardship Exemption Request (PDF) form you submit through the portal.
- Revised FAQs (PDF).
- Ground Ambulance Industry Trends, 2017-2020 Report: Analysis of Medicare Fee-for-Service Claims (PDF).
Bookmark this webpage for upcoming events planned in December 2022.
Health Professional Shortage Area: CY 2023 Bonus Payments
See ZIP Codes designated as Health Professional Shortage Areas in 2023 that are eligible for a Medicare Physician Bonus:
See the instruction to your Medicare Administrative Contractor (PDF).
Rural Health: Help Address Disparities
People living in rural, Tribal, frontier, and geographically isolated areas have unique health care needs. On National Rural Health Day and throughout the month, find out how you can help address these challenges.
More Information:
- Medicare Preventive Services educational tool
- Rural Health webpage
MLN Matters® Articles
ESRD & Acute Kidney Injury Dialysis: CY 2023 Updates
Learn about changes effective January 1, 2023 (PDF):
- Rates and policies for the ESRD Prospective Payment System
- Payment for renal dialysis services provided to patients with acute kidney injury in ESRD facilities
Home Health Prospective Payment System: CY 2023 Update
Learn about changes effective January 1, 2023 (PDF):
- 30-day period payment rates
- National per-visit amounts
- Cost-per-unit payment amounts used for calculating outlier payments under the Home Health Prospective Payment System
Medicare Physician Fee Schedule Final Rule Summary: CY 2023
Learn about updates effective January 1, 2023 (PDF):
- Telehealth originating site facility fee payment amount
- Expansion of coverage for colorectal cancer screening
- Coverage of audiology services
- Other covered services
Publications
Federally Qualified Health Center — Revised
Learn what changed starting January 1, 2022 (PDF):
- Payment for hospice attending physician services by specific providers
- Mental health services using telecommunications
- Concurrent billing for chronic care management and transitional care management services
- Changes to care management services codes
CMS also added information on COVID-19 shot and monoclonal antibody therapy administration.
From Our Federal Partners
Managing Monkeypox in Patients Receiving Therapeutics: CDC Update
Read the Health Alert Network Health Update to get new information about managing monkeypox in patients requiring therapeutics.
Monkeypox cases have declined since mid-August in the U.S.; however, new cases—including clinically severe cases—continue to occur. While there are currently no treatments specifically approved for monkeypox, therapeutics developed for patients with smallpox have been deployed during the current outbreak.
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