All Fee-For-Service Providers
Expired Medicare Legislative Provisions
CMS is committed to implementing the Medicare program in accordance with all applicable laws and regulations, including timely claims processing. Several Medicare legislative provisions affecting providers and beneficiaries recently expired, including exceptions to the outpatient therapy caps, the Medicare physician work geographic adjustment floor, add-on payments for ambulance services and home health rural services, payments for low volume hospitals, and payments for Medicare dependent hospitals. CMS is implementing these payment policies as required under current law.
However, CMS is taking steps to limit the impact on Medicare beneficiaries by holding claims affected by the therapy caps exceptions process expiration for a short period of time beginning on January 1, 2018.
CMS is not holding any other claims except those affected by the therapy caps. If legislation regarding the therapy caps is not enacted in this short period of time, then CMS will release and process the therapy claims accordingly. Under current law, CMS may not pay electronic claims sooner than 14 calendar days (29 days for paper claims) after the date of receipt, but generally pays clean claims within 30 days of receipt.
January 2018 Average Sales Price Files Now Available
CMS posted the January 2018 Average Sales Price (ASP) and Not Otherwise Classified (NOC) pricing files and crosswalks on the 2018 ASP Drug Pricing Files webpage.
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Medicare Fee-for-Service (FFS) Payment
- Fee Schedules - General Information
- Prospective Payment Systems - General Information
- Acute Inpatient PPS
- Ambulance Fee Schedule
- Ambulatory Surgical Center (ASC) Payment
- Clinical Laboratory Fee Schedule
- DMEPOS Competitive Bidding - Home
- Durable Medical Equipment, Prosthetics/Orthotics & Supplies Fee Schedule
- Home Health PPS
- Hospital-Acquired Conditions (Present on Admission Indicator)
- Hospital Outpatient PPS
- Inpatient Psychiatric Facility PPS
- Inpatient Rehabilitation Facility PPS
- Long-Term Care Hospital PPS
- PC Pricer
- Physician Fee Schedule
- Physician Fee Schedule Overview - Opens in a new window
- Physician Bonuses
- Skilled Nursing Facility PPS
Medicare Fee-for-Service Part B Drugs
- Competitive Acquisition for Part B Drugs & Biologicals
- Historical Part B Drug Pricing Files
- Medicare Part B Drug Average Sales Price
- Medicare Coverage - General Information
- Council for Technology & Innovation
- Clarification about Part B versus Part D Drug Coverage [PDF, 85KB]
- DMEPOS Competitive Bidding - Home
- End Stage Renal Disease (ESRD) Center
- ICD-9-CM and ICD-10
- Medicare Provider-Supplier Enrollment
- National Provider Identifier Standard (NPI)
- National Correct Coding Initiative Edits
- Quarterly Provider Updates
- SNF Consolidated Billing
- Supplier Directory - Opens in a new window
- Sustainable Growth Rates & Conversion Factors
- Versions 5010 and D.0 & 3.0
- Review Contractor Directory - Interactive Map
- Quality Improvement Organizations
- CMS Regional Offices