Category: Blog

Medicare Reimbursement for Home Dialysis

CMS Expands Medicare Reimbursement for Home Dialysis, ESRD

New and innovative home dialysis machines will soon qualify for additional Medicare reimbursement, according to the latest End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final rule. CMS released the final rule yesterday, which introduced the new transitional add-on payment for dialysis machines used in patient homes and also included an update to Medicare reimbursement rates […]
ICD-10-PCS Codes for COVID-19 Treatments

ICD-10-PCS Codes for Treating COVID-19

The ICD-10-PCS codes can be found in the XW0 Table for the drug infusions. There were new ICD-10-PCS codes implemented on Aug. 1, involving substances associated with the treatment of COVID-19. As we know, these codes are not to be assigned unless the substances were used to treat coronavirus. Here is some information regarding these […]
COVID-19 Vaccines

Coronavirus: CMS Releases Plan For Vaccine Patient Price, Reimbursement

  The Centers for Medicare and Medicaid Services (CMS) is laying the groundwork for the widespread release of a COVID-19 coronavirus vaccine by releasing an interim final rule with comment period (IFC) with information on out-of-pocket patient costs and physician reimbursements. According to a news release, any vaccine which is authorized by the U.S. Food and […]
Health Systems Innovation

5 Ways Health Systems Can ‘Advance To The New Normal’

  The COVID-19 pandemic created the opportunity for hospitals and health systems to innovate in a short amount of time. Learning how to advance and scale those opportunities will be the key to redesigning the health system of the future, said CommonSpirit Health Senior Vice President and Chief Strategic Innovation Officer Rich Roth, and CommonSpirit […]
RCM Automation

Transforming Revenue Cycle Management Using Automation

In today’s healthcare industry today, there is a lot of buzz and hype surrounding automation. Large healthcare networks, medical facilities, and revenue cycle management service providers alike are looking to achieve a more efficient, robust revenue cycle through automation technologies. Any technology that can free employees to focus on high-value tasks and make revenue cycle […]
Healthcare Price Transparency Rule

CMS Issues Long-Awaited, Controversial Final Rule on Price Transparency

  A long-awaited and controversial final rule on healthcare price transparency was released Thursday by the federal government. The rule, mandated under a June 2019 executive order by President Donald Trump, requires private group health plans and individual health insurance market plans to disclose pricing and cost-sharing information in a consumer-friendly format. The mandate, which takes effect on January […]
Medicare Reimbursement Rates for COVID-19

CMS Sets Medicare Reimbursement Rate for COVID-19 Vaccine

A new interim final rule with comment period ensures Medicare reimbursement for the administration of a COVID-19 vaccine and provider use of innovative treatments for the novel coronavirus. The rule released last night states that Medicare will pay providers $28.39 for the administration of a single-dose COVID-19 vaccine. In the event an approved COVID-19 vaccine requires multiple […]
Telehealth Reimbursement Changes

Telehealth Reimbursement May Be Changing. How Should Providers Prepare?

The future potential of telehealth hinges on how it’s reimbursed. Virtual care may be popular among patients, but if providers can’t get paid for their services, it’s unlikely they’ll be able to continue to provide them. The government has signaled its support for reimbursing some telehealth services, at least in the short term. The Centers […]