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Thursday, March 23, 2023




Claims, Pricers, & Codes


MLN Matters® Articles



Additional Residency Positions: Apply by March 31

You can apply for additional residency positions under Section 126 of the Consolidated Appropriations Act, 2021. Submit FY 2024 applications no later than March 31, 2023. For details, see Direct Graduate Medical Education, and scroll to Section 126: Distribution of Additional Residency Positions.


Laboratory Testing Urinalysis: Comparative Billing Report in March

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

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

More Information:


Long-Term Care Hospital Provider Preview Reports: Review by April 14

Review your data by April 14, and contact CMS if you have questions. We’ll publish the data on Care Compare and in the Provider Data Catalog in June. 

Visit Public Reporting for more information.


Inpatient Rehabilitation Facility Provider Preview Reports: Review by April 14

Review your data by April 14, and contact CMS if you have questions. We’ll publish the data on Care Compare and in the Provider Data Catalog in June.

Visit Public Reporting for more information.


Make Your Voice Heard Summary: Reducing Burden & Increasing Efficiencies

CMS released a summary of the results from its Make Your Voice Heard Request for Information. We gained valuable public insight on topics like accessing healthcare and providers’ experience delivering healthcare. This information will inform our work and better support the populations we serve. Thank you to everyone who sent comments.


Promote Kidney Health During National Kidney Month

Chronic kidney disease (CKD) affects an estimated 37 million Americans, amounting to 1 in 7 U.S. adults, and is most common in people over age 65. Since people with early-stage kidney disease usually don’t experience symptoms, 9 in 10 adults living with CKD remain unaware they have the disease. 

The 2 largest risk factors for CKD are diabetes and hypertension, along with heart disease and obesity. These are all conditions that disproportionately impact minority populations. Those at high risk for CKD should be sure to get tested for the disease regularly. Medicare covers screenings for diabetes and cardiovascular disease.

Your patients pay nothing if you accept assignment. Find out when your patient is eligible for screenings. If you need help, contact your eligibility service provider.

More Information:



Critical Access Hospitals: Bill Correctly

The Information for Critical Access Hospitals (CAH) booklet explains how to properly document and bill for services, including:

  • Bed and board, nursing, and other related services
  • Facilities
  • Medical social services
  • Drugs
  • Biologicals
  • Supplies, appliances, and equipment for inpatient hospital care and treatment

An Office of Inspector General report found that Medicare improperly paid CAHs and health care professionals for the same CAH services. A CAH can only bill for facility and professional outpatient services if the physician or practitioner reassigns their billing rights to them.

Physicians or practitioners providing professional outpatient CAH services can either:

  • Reassign their billing rights to the CAH and agree to the optional payment method. They must attest that they won’t bill for these services.
  • File Medicare Administrative Contractor claims for these services under the Medicare Physician Fee Schedule.

More Information:


Claims, Pricers, & Codes

Integrated Outpatient Code Editor: Version 24.1

CMS posted the April 2023 Integrated Outpatient Code Editor files. Learn about claims processing changes effective April 1, 2023.

See the instruction to your Medicare Administrative Contractor.



Medicare Home Health Prospective Payment System CY 2023 Webinar — March 29

Behavior Change Recap, 60-Day Episode Construction Overview, & Payment Rate Development

Wednesday, March 29 from 1:30–3 pm ET

Register for this webinar.

CMS experts provide an overview of several provisions from the CY 2023 Home Health Prospective Payment System final rule related to behavior changes, the construction of 60-day episodes, and payment rate development.

More Information:


MLN Matters® Articles

Ambulatory Surgical Center Payment System: April 2023 Update

Learn about the April updates:

  • New HCPCS codes for drugs and biologicals
  • Corrected 2023 code pair file
  • Skin substitute product codes


DMEPOS Fee Schedule: April 2023 Updates

Learn about the April updates:

  • Fee schedule amounts for new and existing codes
  • Payment policy changes


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