Thursday, October 24, 2024
News
- CMS Roundup (October 18, 2024)
- Rural Health Clinic & Federally Qualified Health Center: Final CY 2024 Payment Policies
Claims, Pricers, & Codes
MLN Matters® Articles
- Allowing Home Health Telehealth Services During an Inpatient Stay
- Correction for Inpatient Medicare Part B Ancillary 12X Claims & Manual Updates
- Separate Payment for Essential Medicines – New Biweekly Interim Payments for the Inpatient Prospective Payment System
- Inpatient & Long-Term Care Hospital Prospective Payment System: FY 2025 Changes — Revised
From Our Federal Partners
- Biosimilars: Updated Curriculum Toolkit
- Disruptions in Availability of Peritoneal Dialysis & Intravenous Solutions from Baxter International Facility in North Carolina
News
CMS Roundup (October 18, 2024)
You may be interested in these topics from the CMS Roundup:
- Information and Resources in Observance of World Mental Health Day
- Final Rule Establishes Medicare Appeals Process For Eligible Inpatients Reclassified as Outpatients During Hospital Stay
Rural Health Clinic & Federally Qualified Health Center: Final CY 2024 Payment Policies
CMS updated the Medicare Benefit Policy Manual, Chapter 13 (PDF) with CY 2024 requirements and payment policies for Rural Health Clinics and Federally Qualified Health Centers.
More Information:
- Information for Rural Health Clinics (PDF) booklet
- Federally Qualified Health Center (PDF) booklet
- Instruction to your Medicare Administrative Contractor (PDF)
Claims, Pricers, & Codes
Home Health Consolidated Billing: New Physician Specialty Code F6 Excluded
CMS created a new physician specialty code for epileptologists (F6) effective July 1, 2024. This code is excluded from home health consolidated billing for outpatient therapies.
Medicare Administrative Contractors (MACs) will update their systems effective October 1, 2024. They’ll adjust claims processed before October 1, 2024, that you bring to their attention.
More Information:
MLN Matters® Articles
Allowing Home Health Telehealth Services During an Inpatient Stay
Learn about a new exception (PDF) to reporting telehealth services during an inpatient stay.
Correction for Inpatient Medicare Part B Ancillary 12X Claims & Manual Updates
Learn about billing updates (PDF) effective April 1, 2025:
- Editing correction for certain claims
- Processing service dates outside the inlier portion of the stay with occurrence span code 70
- Billing provisions for all items and non-physician services inpatients receive
Your Medicare Administrative Contractor will adjust these claims.
Separate Payment for Essential Medicines – New Biweekly Interim Payments for the Inpatient Prospective Payment System
Learn about changes to payments (PDF) under the Inpatient Prospective Payment System:
- Adjustments for establishing and maintaining access to essential medicines
- How you’ll be paid
- How we’ll determine future payments
Inpatient & Long-Term Care Hospital Prospective Payment System: FY 2025 Changes — Revised
CMS updated the wage index policy (PDF) for certain rural hospitals.
From Our Federal Partners
Biosimilars: Updated Curriculum Toolkit
The FDA updated the Biosimilar Curriculum Toolkit to help educate practicing professionals, physician associates, and students in health care degree programs about biosimilar and interchangeable biosimilar products and the U.S. regulatory approval pathway. The updated toolkit includes:
- More topics and resources
- Modular materials with foundational and more in-depth information
It’s important for health care professionals to expand their awareness and familiarity of biosimilar products, as they’re the primary communicators about the efficacy and impact of biosimilars to patients.
More Information:
Disruptions in Availability of Peritoneal Dialysis & Intravenous Solutions from Baxter International Facility in North Carolina
The CDC issued this Health Alert Network Health Advisory to inform health care providers, pharmacists, health care facility administrators, and state, tribal, local, and territorial health departments of a supply disruption of peritoneal dialysis and intravenous solutions from the Baxter International’s North Cove facility in North Carolina, due to Hurricane Helene. The supply disruption may impact patient care and require adjustments to the clinical management of patients. Regardless of supply chain disruptions, you should immediately assess your supply and develop plans and mitigation strategies to reduce the impact on patient care.
See the full Health Advisory for more information, including recommendations for health care providers.
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