Can You Document and Defend Your Chargemaster Prices Under the 2020 CMS Final Rule?
I’m sure everyone has heard the saying, “the only constant is change.” Well, it certainly rings true these days. The Centers for Medicare & Medicaid Services (CMS) issued a second interim final rule on April 30, offering another round of coding and documentation updates related to telehealth during the public health emergency.
Panacea has summarized the Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) payment and coding updates, effective July 2020 (with some retroactive changes). Please review the updates for possible implementation in your hospital chargemaster and/or review by applicable department, coding and billing staff.
As many of you have heard, there are major changes coming to evaluation and management (E&M) codes in 2021. The changes were finalized in the 2020 Physician Final Rule.
In response to the comments received from the CMS-1744-IFC issued March 26, 2020, there are several updates related to Telehealth and/or Telemedicine and the Physician Supervision Rules.
Read Unpacking CMS’ 2020 Proposed Expanded Rules for Hospital Price Transparency to gain a better understanding of the Proposed Rules for Hospital Price Transparency released by CMS on July 29, 2019. The comment period ended September 27, 2019, and the final rule is forthcoming.
On January 1, 2019 the Hospital Price Transparency Rule took effect mandating hospitals publish their price lists online in a machine-readable format. Hospitals complied by making their charge description master (CDM) available via download in CSV or similar format. The result fell far short of CMS’ goal of empowering patients to become “active healthcare consumers” and the agency on July 29, 2019, in response to the Trump administration Executive Order on Price and Quality Transparency, proposed expanded rules aimed at more “consumer friendly” transparency.
We’ve summarized the Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) payment and coding updates being implemented October 1, 2019. The updates should be reviewed for possible implementation in your hospital chargemaster and/or reviewed by applicable coding and billing staff.
As laboratory services are one of the highest revenue-producing departments in most health systems, it’s incredibly important to bill these services correctly. However, it’s also an area fraught with lots of guidelines and restrictions—and with many staff members throughout the hospital system working laboratory accounts, there is a high risk of errors and inconsistencies. This is a situation we’ve seen and helped correct in health systems nationwide.
On August 2, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that was intended to empower patients through better access to hospital price information. Current laws already required hospitals to make public a list of their standard charges, but the new requirement which became effective on January 1, 2019, required hospitals to publish a list of all charges in machine readable format via the internet, in an XML or CSV format. The final rule also required providers to update their posted charges no less than one time per year.