CMS released the fiscal year (FY) 2023 inpatient prospective payment system proposed rule with proposals for new calculations for FY 2023 rate setting. Although CMS is proposing to use FY 2021 data for FY 2023 Medicare Severity Diagnosis-Related Groups (MS-DRG) rate setting, the agency wants a modified methodology to account for the historical and potential […]
As the nation began experiencing an uptick in COVID-19 cases this fall, a similar upswing occurred in the use of telehealth, according to the latest report from FAIR Health, an independent, nonprofit organization, which tracks commercial insurance claims as part of a healthcare cost transparency initiative. Compared to one year ago, October usage of telehealth increased […]
CMS provided clarification on submitting inpatient claims for patients diagnosed with novel coronavirus (COVID-19) without a positive viral test, in an update to MLN Matters SE20015 released September 11. Earlier this year, the CARES Act increased the MS-DRG weighting by 20% for a COVID-19 diagnosis. Although the CARES Act doesn’t specify that the diagnosis must be supported by a […]
Payers are reimbursing providers for all COVID-19-related testing and treatment they are furnishing to their insured members, but what if the patient is uninsured? Healthcare providers need not write off COVID-19 testing and treatment services rendered to uninsured patients. Compensation is available! The public health emergency for COVID-19 requires the healthcare industry to focus their […]
COVID-19 is affecting all aspects of healthcare and has even led the Centers for Disease Control and Prevention (CDC) to take the unprecedented step of introducing a new code, outside of its usual time cycle, which negates the code introduced just weeks ago. Usually, new ICD codes are introduced to healthcare after months of deliberation […]