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2022 Payment, Quality, & Policy Changes

Thursday, March 3, 2022



Claims, Pricers, & Codes


MLN Matters® Articles






Ambulance Prior Authorization Model Expands April 1

On April 1, the Repetitive, Scheduled Non-Emergent Ambulance Transport Prior Authorization Model will expand to Florida, Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, Puerto Rico, Wisconsin, and the U.S. Virgin Islands.

Visit the Prior Authorization of Repetitive, Scheduled Non-Emergent Ambulance Transport webpage for the timeline, updates, and other information.


Nutrition-related Health Conditions: Recommend Medicare Preventive Services

Did you know that Medicare covers 6 preventive services for nutrition-related health conditions like diabetes, chronic kidney disease, and obesity?

  1. Medical nutrition therapy
  2. Diabetes screening
  3. Diabetes self-management training
  4. Intensive behavioral therapy for obesity
  5. Intensive behavioral therapy for cardiovascular disease
  6. Annual wellness visit

During National Nutrition Month®, encourage your patients to develop healthy eating patterns and make food choices to meet their individual nutrient needs, goals, backgrounds, and tastes.

More Information:


Claims, Pricers, & Codes


HCPCS Application Summaries & Coding Decisions: Drugs and Biologicals

CMS published the fourth quarter 2021 HCPCS Level II Application Summary and Coding Decisions for Drugs and Biologicals (PDF). Visit the HCPCS Level II Coding Decisions webpage for more information.




ICD-10 Coordination & Maintenance Committee Meeting — March 8–9

Tuesday, March 8–Wednesday, March 9

If you need proof of attendance for continuing education, register here.

We’ll post the agenda and related materials before the meeting:


MLN Matters® Articles


An Omnibus CR Covering: (1) Removal of Two National Coverage Determination (NCDs), (2) Updates to the Medical Nutrition Therapy (MNT) Policy, and (3) Updates to the Pulmonary Rehabilitation (PR), Cardiac Rehabilitation (CR), and Intensive Cardiac Rehabilitation (ICR) Conditions of Coverage

Learn about updates from the calendar year 2022 Medicare Physician Fee Schedule final rule (PDF).


The Supplemental Security Income (SSI)/Medicare Beneficiary Data for Fiscal Year (FY) 2020 for Inpatient Prospective Payment System (IPPS) Hospitals, Inpatient Rehabilitation Facilities (IRFs), and Long Term Care Hospitals (LTCHs)

Learn about updated data files that CMS uses to (PDF):

  • Calculate disproportionate share adjustment for IPPS hospitals
  • Calculate low-income patient adjustment for IRFs
  • Pay for certain LTCH discharges




Medicare Payment Systems — Revised

Learn about 2022 regulation changes to payment, quality, and policy for:

  • Acute care hospital
  • Hospice
  • Skilled nursing facility
  • Ambulatory surgical center
  • Hospital outpatient
  • Inpatient psychiatric facility
  • Inpatient rehabilitation facility
  • Long-term care hospital
  • Durable medical equipment, prosthetics, orthotics, & supplies (New)
  • Home health

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