Thursday, March 6, 2025
News
- Therapy Services: Get Updates for CY 2025
- Hospitals: Apply for Additional Residency Positions by March 31
Compliance
Claims, Pricers & Codes
- Updated ICD-10 Medicare Severity Diagnosis-Related Group Version 42.1
- Inpatient Psychiatric Facilities Prospective Payment System: April 2025 Coding Updates
MLN Matters® Articles
News
Therapy Services: Get Updates for CY 2025
CMS posted revised therapy services files for CY 2025:
- Multiple procedure payment reduction rates (ZIP) reflect the extension of the work geographic index floor of 1.0
- Therapy Code List and Dispositions (ZIP) : disposition 10 clarifies that the telephone codes can be furnished by therapists as telehealth services but only through March 31, 2025
Visit Therapy Services for more information.
Hospitals: Apply for Additional Residency Positions by March 31
Apply for additional residency positions by March 31, 2025. See Direct Graduate Medical Education for information on additional residency positions under:
- Section 126 of the Consolidated Appropriations Act, 2021 (round 4 applications):
- Section 4122 of the Consolidated Appropriations Act, 2023:
Compliance
Oral Anticancer & Antiemetic Drugs: Prevent Claim Denials
In 2023, the improper payment rate for oral anticancer and antiemetic drugs was 84% with a projected improper payment amount of $48.9 million (see 2023 Medicare Fee-for-Service Supplemental Improper Payment Data (PDF), Appendices D, E, G, and F). Learn how to bill correctly for these services. Review the Oral Anticancer & Antiemetic Drugs provider compliance tip for more information, including:
- Billing codes
- Denial reasons and how to prevent them
- Refill and documentation requirements
- Example of improper payments due to insufficient documentation
- Resource
Claims, Pricers & Codes
Updated ICD-10 Medicare Severity Diagnosis-Related Group Version 42.1
See Medicare Severity Diagnosis-Related Group (MS-DRG) Classifications and Software for:
- Updated ICD-10 MS-DRG grouper software, Version 42.1
- ICD-10 MS-DRG Definitions Manual
- Definitions of Medicare Code Edits
See the instruction to your Medicare Administrative Contractor (PDF).
Inpatient Psychiatric Facilities Prospective Payment System: April 2025 Coding Updates
See the instruction to your Medicare Administrative Contractor (PDF) for ICD-10 code updates to the Oncology Treatment Procedures List effective April 1, 2025.
MLN Matters® Articles
Roster Billing for Hepatitis B: July 2025 Release
Learn about updates effective January 1, 2025 (PDF):
- Expanded vaccine coverage
- Patients no longer need a doctor’s order
- Mass immunizers can use the roster billing process to submit claims
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