All Fee-For-Service Providers
April 2019 Average Sales Price Files Now Available
CMS posted the April 2019 Average Sales Price (ASP) and Not Otherwise Classified (NOC) pricing files and crosswalks on the 2019 ASP Drug Pricing Files webpage.
Medicare Expired Legislative Provisions Extended and Other Bipartisan Budget Act of 2018 Provisions
On February 9, 2018, President Trump signed into law the Bipartisan Budget Act of 2018. This new law includes several provisions related to Medicare payment.
With regard to payment for outpatient therapy services, the law repeals application of the Medicare outpatient therapy caps but retains the former cap amounts as a threshold above which claims must include the KX modifier as a confirmation that services are medically necessary as justified by appropriate documentation in the medical record; and retains the targeted medical review process, but at a lower threshold amount. It also extends several recently expired Medicare legislative provisions affecting health care providers and beneficiaries, including the Medicare physician fee schedule work geographic adjustment floor, add-on payments for ambulance services and home health rural services, changes to the payment adjustment for low volume hospitals, and the Medicare dependent hospital program.
In addition, with regard to Section 53111 – Medicare Payment Update for Skilled Nursing Facilities, the Centers for Medicare & Medicaid Services has received questions from stakeholders about the impact of the FY 2019 Skilled Nursing Facility (SNF) update due to section 53111 of the BBA of 2018. To help answer these questions, we are providing information about the estimated market basket update for FY 2019 based on currently available data. This estimate may be updated in the Notice of Proposed Rulemaking for the FY 2019 SNF Prospective Payment System (PPS).
Read the full summary.
- New Option for Submission of Medicare Cost Reports
As part of the Centers for Medicare & Medicaid Services (CMS) commitment to decrease the hours and dollars clinicians and providers spend on CMS-mandated compliance and increase the proportion of tasks that CMS customers can do digitally, a new web portal will be made available to submit a Medicare Cost Report (MCR). Specifically, Part A providers will have the option to electronically transmit their MCR through the Medicare Cost Report e-Filing (MCReF) system. MCReF will be available for cost reporting periods ending on or after December 31, 2017.New Option for Cost Report Submission [PDF, 17KB]
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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