Dynamic List Information
Dynamic List Data
Weekly Edition
MLN Connects logo

Thursday, February 23, 2023


Claims, Pricers, & Codes




Hospital Price Transparency: Progress and Commitment to Achieving Its Potential

Excerpt: Pricing information has long been opaque in the health care marketplace. Lack of transparent information on prices makes it challenging for consumers to shop for services and limits competition. Over the past several years, CMS has implemented or is in the process of implementing complementary groundbreaking policies to promote transparency across the health care system.

In a blog post in Health Affairs, CMS authors focus on the Hospital Price Transparency regulations, which became effective January 1, 2021, and require each hospital operating in the United States to make public its standard charges for the items and services it provides. Recent CMS analyses of how hospitals are putting the hospital price transparency requirements into practice demonstrate a substantial increase in hospitals meeting website assessment criteria from 27% to 70% between 2021 and 2022. This improvement results from an increase in penalties for noncompliance, and significant education, monitoring, and enforcement activities.

Despite the improvement, all hospitals must fully comply with the law, and CMS is exploring additional policies to accomplish this as well as examining ways to make healthcare pricing information more usable for consumers.

Read the full blog at Health Affairs


Home Infusion Therapy Services Monitoring Report

Read the February 2023 Home Infusion Therapy Monitoring Report about benefit use from the first quarter 2020 – second quarter 2022, including:

  • Visits
  • Patients
  • Supplier organizations

More Information:


Immunosuppressive Drugs: Comparative Billing Report in February

This month, CMS will issue a Comparative Billing Report (CBR) on Medicare Part B claims for immunosuppressive drugs. Use the data-driven report to compare your billing practices with those of your peers in your state and across the nation.

Look for an email from cbrpepper.noreply@religroupinc.com to access your report.

More Information:


Expanded Home Health Value-Based Purchasing Model Resources: Submit Feedback through March 31

CMS wants to give you the information you need to successfully participate in the Home Health Value-Based Purchasing Model. Provide your feedback:

  • Do current resources meet your needs?
  • What other topics should we cover?

Responses are anonymous, unless you choose to share your name and email.


Claims, Pricers, & Codes

HCPCS Level II Coding: FAQs for Single Source Drugs & Biologicals

CMS published FAQs for coding single source drugs and biologicals. For more information, see HCPCS Coding Questions.


National Correct Coding Initiative: No April Update

CMS isn’t updating any National Correct Coding Initiative edit files this April. Continue using the January edit files until we post the July files.



DMEPOS Quality Standards — Revised

Learn what’s changed:

  • Discontinued Certificates of Medical Necessity and Durable Medical Equipment Information Forms
  • Added items that support medical necessity in a patient’s medical record
  • Replaced the National Supplier Clearinghouse with 2 National Provider Enrollment contractors


Subscribe to the MLN Connects® newsletter. You can read previous issues in the archive.

View the Medicare Learning Network® Content Disclaimer and Department of Health & Human Services Disclosure.

The Medicare Learning Network®, MLN Connects®, and MLN Matters® are registered trademarks of the U.S. Department of Health & Human Services (HHS).