“On July 31, 2020, the Centers for Medicare & Medicaid Services (CMS) issued a final rule [CMS-1737-F] for Fiscal Year (FY) 2021 that updates the Medicare payment rates and the value-based purchasing program for skilled nursing facilities (SNFs). CMS is publishing this final rule consistent with the legal requirements to update Medicare payment policies for SNFs on an annual basis. …
Administration Proposes to Expand Telehealth Benefits Permanently for Medicare Beneficiaries Beyond the COVID-19 PHE
This Press Release announced CMS changes as well as an Executive Order signed on Monday, August 3, 2020. “The Centers for Medicare & Medicaid Services (CMS) is proposing changes to expand telehealth permanently, consistent with the Executive Order on Improving Rural and Telehealth Access that President Trump signed today. The Executive Order and proposed rule advance our efforts to improve …
COVID-19 FAQs on Medicare Fee-for-Service Billing Updated Again
This 140-page COVID-19 FAQ document was updated on July 28, 2020. This is what’s new in this version during July: Page 10 – Diagnostic Laboratory Services … Question: If a physician/non-physician practitioner (NPP) reports CPT code 99211 “Office or other outpatient visit for the evaluation and management of an established patient that may not require the presence of a physician”, …
News Alert: Provider Reimbursement Available for Counseling Patients to Self-Isolate at Time of COVID-19 Testing
The following News Alert was issued mid-day on Thursday, June 30, 2020: CMS and CDC announce provider reimbursement available for counseling patients to self-isolate at time of COVID-19 testing Today, the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) are announcing that payment is available to physicians and health care providers to …
Hospice PEPPER Now Available
The Q4FY19 release of the Hospice Program for Evaluating Payment Patterns Electronic Report (PEPPER) with statistics through September 2019 is now available for download through the PEPPER Resources Portal. To obtain your Hospice PEPPER, the Chief Executive Officer, President, Administrator, Compliance Officer, or Quality Assurance/Performance Improvement Officer of your organization should: Review the Secure PEPPER Access Guide. Review the instructions and obtain …
OIG Report: Medicare Overpaid HHAs $191.8 Million
The Office of Inspector General released a report this last week of July that revealed overpayment of home health agencies. The OIG audit covered approximately $1.25 billion in Medicare payments to HHAs for 549,768 claims. These claims were for home health services provided in CY 2017. Because of the large increase in payment starting with the fifth visit, OIG focused …
ICD-10-CM changes take effect Oct. 1 – are you prepared?
Join Lisa as she discusses the changes slated for October 1, including new codes, guidelines, and Coding Clinic guidance pertinent to home care and hospice. Do you understand the impact of your coding on PDGM? What are the more common errors that you can avoid? Learn the latest and get your questions answered for only $49. [Live webinar] New codes, …
[Free webinar, Jul 29] Prepping for PBJ quarterly success: Critical answers to your top questions
After a bumpy three-month ride, PBJ reporting is back on track for the quarter. In late March, CMS issued a staffing data submission waiver due to the COVID-19 public health emergency. On June 25, that waiver ended – which means PBJ reporting requirements for the quarter are back in effect. In this free webinar, find out the latest PBJ news and get …
SNF PEPPER Reports Are Coming
In case you forgot about your annual PEPPER report, CMS has not. CMS has directed the PEPPER team to resume distribution of PEPPER reports to all post-acute facilities. The SNF Q4FY report will be delivered on July 29, 2020. It was originally scheduled for release on April 6, 2020 but it was held at that time due to the COVID-19 …
Recent COVID-19 Information and Updates: 2nd Week of July
MLN Matters Number: SE20011 Revised was posted on Friday, July 17, 2020 This is a 16-page MLN. Look for the red ink within this document. The first occurrence is found on page 11. Keep reading as there is more clarification regarding the SNF Benefit Period Waiver as well as billing. Testing Guidelines for Nursing Homes were updated by CDC on …