By
The final rule on provider-based clinics is expected in early November. To understand changes being made relative to provider-based clinics, both Federal Registers must be read, and due to the complexity of the language, studied with care. Note that these are proposed rule changes. We will have to wait until…
By
Confusion persists as providers anxiously await facility-specific guidelines from CMS. Did UHC provide to facilities an ED criterion to use when assigning facility ED evaluation and management (E&M) codes to their patients?  Probably not.  Based on this, most facilities have used the Centers for Medicare & Medicaid Services (CMS) instructions…
By
The OPPS Final Rule encompasses a wide variety of subjects while providing a roadmap of issues CMS will be monitoring in 2018. The examination copy of the Outpatient Prospective Payment System (OPPS) update in the latest edition of the Federal Register is 1,133 pages long! This will translate into about…