Critical Access Hospitals Center
MLN Matters® Special Edition Article #SE1508 on Physician Quality Reporting System 2013 Reporting Year and 2015 Payment Adjustment for RHCs, FQHCs, and CAHs Released
On March 6, 2015, MLN Matters® Special Edition Article #SE1508, “Guidance on the Physician Quality Reporting System (PQRS) 2013 Reporting Year and 2015 Payment Adjustment for Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), and Critical Access Hospitals (CAHs),” was released. This article is designed to provide education on the PQRS 2013 reporting year and 2015 payment adjustment for RHCs, FQHCs, and CAHs.
- Critical Access Hospitals Located in Counties That Will Lose Rural Status and Become Urban FY 2015 [PDF, 150KB]
- Additional Clarification of Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions
On August 19, 2013, in the FY2014 IPPS/LTCH final rule CMS clarified and revised the conditions of payment for hospital inpatient services under Medicare Part A related to patient status. On September 5, 2013, CMS released guidance that discussed the provisions of the final rule regarding the physician order and physician certification of hospital inpatient services. This document includes further clarification of issues addressed in the previous guidance.
Prior Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions
The guidance provided in this document has been further clarified in Additional Clarification of Guidance on the Physician Order and Physician Certification for Hospital Inpatient Admissions. This version of the guidance document will remain online for comparison purposes.
- CMS Rule 1599-F: Inpatient Hospital Admission and Medical Review Criteria (2-Midnight Provision) and Part B Inpatient Billing in Hospitals
CMS hosted a Special Open Door Forum (ODF) call to allow hospitals, practitioners, and other interested parties to give feedback on the physician order and physician certification, inpatient hospital admission and medical review criteria, and Part B inpatient billing provisions that were released on August 2, 2013 in the FY 2014 Inpatient Prospective Payment System (IPPS) final rule (CMS-1599-F). This introductory call allowed for initial discussions between stakeholders and CMS. The transcript and MP3 audio file will be posted to the Special ODF web page under the "Downloads" section around August 22 and will be available for 30 days. CMS understands that providers or associations may have additional questions or concerns. You are encouraged to submit questions related to the two midnight provision for admission and medical review to the IPPSadmissions@cms.hhs.gov mailbox. Questions on Part B inpatient billing and the clarifications regarding the physician order and certification should be sent to the subject matter staff listed in the final rule. CMS will review stakeholder feedback as quickly as possible and provide responses and clarification as needed.
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- Physician Bonuses
- MLN Matters Article SE0453 [PDF, 67KB] : MMA-Proposed Implementation of the Physician Scarcity Bonus and Revision to the Health Professional Shortage Area (HPSA)
- Skilled Nursing Facility PPS
- Survey & Certification - General Information
- Critical Access Hospitals
- Form CMS-2802E - Request for Validation of Accreditation for Critical Access Hospital Survey
- MLN General Information
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- MLN Matters Articles ( Search Tips )
- MLN Products
- Physician Regulatory Issues Team (PRIT)
- Choosing to Convert to Critical Access Hospital Status -- Health Care Financing Review: Fall 2003 Edition Article
- Frequently Asked Questions - Opens in a new window
- Press Releases - Opens in a new window
- Internet-Only Manuals (IOMs)
- Claims Processing Manual - Chapter 4 - Part B Hospital (Including Inpatient Hospital Part B and OPPS) [PDF, 1MB] - Special Rules for Critical Access Hospital Outpatient Billing
- CMS Regional Office Rural Health Coordinators - Updated January 2015 [PDF, 63KB]
- Quality Improvement Organizations (QIO)
- CMS Regional Offices
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- Hospitals Open Door Forum