May 24, 2018 | Physician Fee Schedule, Physicians
Medicare Part B reimburses for physician services according to the physician fee schedule (PFS). The MPFS includes over 7,000 physician service codes and their payment rates. In this brief, we’ll provide an overview of how payments are determined, and how rates can be as much as 20% to 25% higher due to geographic adjustments, as our example for cataract procedures highlights. Click to read more.
May 22, 2018 | Inpatient Psych
CMS recently released proposed updates to the Inpatient Psychiatric Facilities (IPF) Prospective Payment System (PPS). The proposed rule would update the IPF Quality Reporting Program and prospective payment rates for discharges occurring during FY2019. Click to read more.
May 21, 2018 | Inpatient Rehab (IRF)
On April 27, CMS released proposed updates to the FY2019 Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS). The proposed rule includes updates to IRF payment rates, changes to the IRF quality reporting program, and revisions to IRF coverage requirements. This brief will discuss highlights from the proposal. Click to read more.
May 14, 2018 | Medicare, Physicians
The CMS Innovation Center (CMMI) recently announced that it is exploring a direct provider contracting (DPC) initiative to enhance the physician-beneficiary relationship. Such a model would permit providers to have increased accountability for the cost and quality of a designated population in efforts to improve beneficiary outcomes. CMMI has put forth an RFI as it works to develop a model. Meanwhile, some beneficiary advocates are skeptical, as they believe it may discriminate against lower-income individuals. Click to read more.
