Tag: Claims Reimbursement

hospital-pros-and-cons-of-the-cy-2022-opps-proposed-rule

Hospital Pros and Cons of the CY 2022 OPPS Proposed Rule

Hospital groups are digesting the 863-page CY 2022 OPPS proposed rule, but many are already commenting on new hospital price transparency penalties and other policies. The newly proposed Medicare Outpatient Prospective Payment System (OPPS) rule for calendar year (CY) 2022 is causing a stir with new hospital price transparency enforcement rules and other policies. The […]
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hrsa-over-5m-claims-paid-for-uninsured-covid-19-vaccinations

HRSA: Over 5M Claims Paid for Uninsured COVID-19 Vaccinations

The Health Resources and Services Administration (HRSA) has paid over 5 million claims for COVID-19 vaccinations of uninsured Americans, according to a recent announcement. The claims were paid through the HRSA COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing, Treatment, and Vaccine Administration for the Uninsured, a program funded by pandemic-related legislation […]
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COVID-19-Testing-Uninsured-Reimbursement

$4.8B to COVID-19 Testing Reimbursement for the Uninsured

HHS will designate $4.8B from the American Rescue Plan to COVID-19 testing reimbursement under the HRSA COVID-19 Uninsured Program. Under the Health Resources and Services Administration (HRSA), HHS announced it will allocate $4.8 billion to COVID-19 testing reimbursement for the uninsured as part of the American Rescue Plan. There are currently approximately 29 million uninsured […]
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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 […]
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COVID-19 Antigen Testing

New CPT Code Expands COVID-19 Coding, Billing to Antigen Tests

The AMA’s new Category I CPT code will allow for COVID-19 coding and billing of antigen tests performed on patients suspected of being infected by the novel coronavirus. The American Medical Association (AMA) recently updated Current Procedural Terminology (CPT) to enable proper COVID-19 coding and billing of antigen tests performed on patients suspected of being infected with […]
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Telehealth Reimbursement

Providers Want Equal Telehealth Reimbursement Beyond COVID-19

With telehealth reimbursement flexibilities set to expire following the public health emergency period, providers are calling on HHS and policymakers to continue payment parity beyond COVID-19. Telehealth use has increased dramatically in a matter of weeks, enabling providers to continue seeing patients despite social distancing and shelter-at-home restrictions due to COVID-19. But these advancements could […]
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COVID-19 Documentation

Documentation to Ease Medical Billing Issues Due to COVID-19

A healthcare lawyer advises providers to thoroughly document care delivery to prevent medical billing and payment issues likely to arise from the COVID-19 pandemic. Clinical documentation is critical to serving patients with COVID-19, but also avoiding medical billing and payment issues in the months and years following the pandemic, according to healthcare lawyer Delphine O’Rourke. “There’s […]
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