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Wednesday, November 23, 2022


MLN Matters® Articles


From Our Federal Partners



Colorectal Cancer Screening Test: Reduced Coinsurance for Related Procedures Begins January 1

Currently, planned colorectal cancer screening tests are free. However, if you add a procedure in the same clinical encounter as a result of the colorectal cancer screening, the patient pays a coinsurance.

Beginning January 1, 2023, CMS will gradually reduce coinsurance for procedures performed:

  • In connection with a colorectal cancer screening test
  • As a result of a screening test
  • In the same clinical encounter as the screening test

The reduced coinsurance applies regardless of the code you bill.

For dates of service in CYs:

  • 2023–2026, coinsurance is 15%
  • 2027–2029, coinsurance is 10%
  • Beginning 2030, no coinsurance

Learn more about phasing out coinsurance (PDF).


Ambulance Fee Schedule: CY 2023 Inflation Factor & Productivity Adjustment

The CY 2023 Ambulance Inflation Factor is 8.7%. For more information, see the instruction to your Medicare Administrative Contractor (PDF).


Medicare Ground Ambulance Data Collection System: Information to Help You Report

Get the latest information on the Medicare Ground Ambulance Data Collection System (GADCS). Starting January 1, selected ground ambulance organizations in Year 1 and Year 2 may report data through the GADCS portal. Other highlights include:

Bookmark this webpage for upcoming events planned in December 2022.


Health Professional Shortage Area: CY 2023 Bonus Payments

See ZIP Codes designated as Health Professional Shortage Areas in 2023 that are eligible for a Medicare Physician Bonus:

See the instruction to your Medicare Administrative Contractor (PDF).


Rural Health: Help Address Disparities

People living in rural, Tribal, frontier, and geographically isolated areas have unique health care needs. On National Rural Health Day and throughout the month, find out how you can help address these challenges.

More Information:


MLN Matters® Articles

ESRD & Acute Kidney Injury Dialysis: CY 2023 Updates

Learn about changes effective January 1, 2023 (PDF):

  • Rates and policies for the ESRD Prospective Payment System
  • Payment for renal dialysis services provided to patients with acute kidney injury in ESRD facilities


Home Health Prospective Payment System: CY 2023 Update

Learn about changes effective January 1, 2023 (PDF):

  • 30-day period payment rates
  • National per-visit amounts
  • Cost-per-unit payment amounts used for calculating outlier payments under the Home Health Prospective Payment System


Medicare Physician Fee Schedule Final Rule Summary: CY 2023

Learn about updates effective January 1, 2023 (PDF):

  • Telehealth originating site facility fee payment amount
  • Expansion of coverage for colorectal cancer screening
  • Coverage of audiology services
  • Other covered services



Federally Qualified Health Center — Revised

Learn what changed starting January 1, 2022 (PDF):

  • Payment for hospice attending physician services by specific providers
  • Mental health services using telecommunications
  • Concurrent billing for chronic care management and transitional care management services
  • Changes to care management services codes

CMS also added information on COVID-19 shot and monoclonal antibody therapy administration.


From Our Federal Partners

Managing Monkeypox in Patients Receiving Therapeutics: CDC Update

Read the Health Alert Network Health Update to get new information about managing monkeypox in patients requiring therapeutics.

Monkeypox cases have declined since mid-August in the U.S.; however, new cases—including clinically severe cases—continue to occur. While there are currently no treatments specifically approved for monkeypox, therapeutics developed for patients with smallpox have been deployed during the current outbreak.


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