Spotlight
Spotlights
Guidance on Billing Medicare for Remote Intraoperative Neurophysiology Monitoring
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 (PDF) 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.
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.
Physician Groups of 100 or More: The Registration Period to Avoid a -1% Payment Adjustment Extended to Friday, October 18 - The Physician Value-Physician Quality Reporting System (PV-PQRS) Registration System is open through October 18, 2013. Representatives of group practices can select their group’s PQRS reporting mechanism for CY 2013, and groups with 100 or more eligible professionals (EPs), can elect quality tiering to calculate the Value Modifier for CY 2015.
The PV-PQRS Registration System can be accessed at https://portal.cms.gov using a valid IACS User ID and password. For additional information regarding registration and obtaining or modifying an IACS account, please see the Quick Reference Guide on the Self Nomination/Registration web page.
- Frequently Asked Questions Regarding Change Request 7631 (Transmittal 2679) (PDF)--Revised and Clarified Place of Service (POS) Coding Instructions.
Revised Fact Sheet for Referral Agents - Where are the Round 2 areas? What if a beneficiary travels? What do you need to know before prescribing a DMEPOS item or referring the beneficiary to a DMEPOS supplier? Want more information on the national mail-order program for diabetic testing supplies?
For answers to these questions and more, see the revised “Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Competitive Bidding Program: Referral Agents (PDF)” Fact Sheet (ICN 900927), which is now available in downloadable format.
- Medicare FFS Physician Feedback Program/Value-Based Payment Modifier
Important Links
Billing / Payment
- Medicare FFS Physician Feedback Program/Value-Based Payment Modifier
- CMS Recognized P-C IOLS and A-C IOLs (PDF)
- PFS Carrier Specific Files
- PFS Relative Value Files
- PFS National Payment Amount File
- Electronic Billing & EDI Transactions
- Medicare National Correct Coding Initiative (NCCI) Edits
- Physician Fee Schedule
- Sustainable Growth Rates & Conversion Factors
- Competitive Acquisition for Part B Drugs & Biologicals
- Physician Bonuses
- Consolidated Billing
- SNF Consolidated Billing
- Office-based Opioid Use Disorder Treatment Billing
- Psychological and Neuropsychological Tests
- Telehealth
Coding
Coverage
Educational Resources
- MLN General Information
- MLN Matters Articles
- MLN Multimedia
- MLN Publications
- Preventive Services - Information on various activities geared toward disease prevention and health promotion
- Preventive Services Educational Tool
Enrollment/ Participation/ Certification
- CMS 460 (90 KB) (PDF) About Medicare Participation: Information about accepting assignment.
- Medicare Provider-Supplier Enrollment
- Enrollment Applications
- Survey & Certification - General Information
Accountable Care Organizations Workshop
- Recordings and Transcripts for the October 5, 2010 Workshop Regarding Accountable Care Organizations, and Implications Regarding Antitrust, Physician Self-Referral, Anti-Kickback, and Civil Monetary Penalty (CMP) Laws (Posted 10/19/10):
- 10-5-10ACO-WorkshopAMSessionTranscript (PDF)
- 10-5-10ACO-WorkshopPMSessionTranscript (PDF)
CMS Manuals & Transmittals
- Manuals
- Internet-Only Manuals (IOMs)
- Transmittals
- Paper-Based Manuals -- Crosswalks from Paper-Based Manuals to Internet-Only Manuals
- To receive changes to the CMS Quarterly Provider Update, subscribe to the CMS-QPU Listserv from the CMS Mailing Lists Page.
- Medicare NCD Manual
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How to Stay Informed
- Subscribe now to get the weekly MLN Connects® newsletter for the latest Fee-for-Service program information, event announcements, claims and pricer information, and MLN educational resources.
- Physicians, Nurses and Allied Health Professionals Open Door Forum
- Media Release Database (includes Press Releases, Fact Sheets, Testimonies, and Speeches)
- Research Reports: A series of reports on the health care industry.
Initiatives
Medicare Prescription Drug Coverage
Medicare Secondary Payer
National Provider Identifier
Specialty Hospitals
Specialty Web Pages
Value-Based Purchasing Information
- "Medicare Value-Based Purchasing Program for Physician and Other Professional Services Listening Session" -- December 9, 2008: Medicare_PVBPP_Listg_Sess_Transcript_12-09-2008 (PDF) , PVBP_LS_Agenda_12-09-08 (PDF) , PVBP_LS_Meeting_12-09-08 (ZIP) PhysicianVBP-Plan-Issues-Paper (PDF) regarding development of a Plan to transition to Medicare Value-Based Purchasing for Physician and Other Health Professional Services. The Plan was mandated by the Medicare Improvements for Patients and Providers Act of 2008.
- - Medicare Program; Plan to Transition to a Medicare Value-Based Purchasing Program for Physician and Other Professional Services: Listening Session, December 9, 2008. Published October 24, 2008.