CMS reimbursement cuts have no negative impact on beneficiary access — 5 things to know

CMS maintains reimbursement cuts in non-competitive bidding areas have not had a negative effect on beneficiary access, according to HME News.

Advertisement

Here are five things to know:

1. On Jan. 1, 2016, Medicare began paying for home medical equipment in regional and rural areas based on a 50/50 blend of the current fee schedule and adjusted rates from its competitive bidding program. On July 1, it will base pricing 100 percent on adjusted rates.

2. CMS counted the claims assignment rates for durable medical equipment, prosthetics/orthotics and supplies items for the first four months of 2015. These items were paid at the unadjusted fee schedule rates. CMS then compared the rate of assignment claims for the same items for the first four months of 2016. Those items were paid at the new partially adjusted rates.

3. Overall, there was no change in the rate of assignment for the first four months of 2016 (99.88 percent) compared to the first four months in 2015 (99.87 percent).

4. There was also no change in the assignment rate in rural areas in 2016 (99.9 percent) compared to 2015 (99.9 percent).

5. The assignment rate in non-contiguous areas changed slightly in 2016 (99.81 percent) compared to 2015 (99.90 percent).

More articles on coding, billing & collections:
Indiana surgery centers file lawsuits against UnitedHealthcare for overpayments — 6 things to know
7 key findings on physicians not understanding medical test & procedure costs
CMS approves California’s new healthcare tax — 5 things to know

At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.

Register to Attend Webinar

Is ambulatory care healthcare’s big margin engine? 4 leaders weigh in

Wednesday, July 29
1:00 PM - 2:00 PM CDT

Presenters: Joe Ganley, athenahealthJeffrey Flynn, CASC, Gramercy Surgery CenterBryan Tsao, Access Center, Loma Linda University HealthJason Zepeda, Northridge Hospital Medical Center, CommonSpirit HealthGreg DeConciliis, PA-C, CASC, Boston Out­Patient Surgical Suites

Advertisement

Next Up in ASC Coding, Billing & Collections

Advertisement

Comments are closed.