CMS Proposed Changes in Hospital ED Payments

September 9, 2013
Rick Gawenda

The Centers for Medicare and Medicaid Services (CMS) is proposing to change the way it reimburses hospitals for facility fees for  emergency department visits. CMS officials want to replace five escalating price codes hospitals can choose from in billing facility fees with one flat rate, starting next year. The 2013 rates for ED facility fees start at $51.82 for a Level 1 patient visit and move up to $344.71 at the top range. For 2014, the CMS is proposing a new flat rate of $212.90 for ED visits, regardless of how intensive the treatment is. To read the full story from, click HERE.

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  1. As a Hospital based Therapy provider PBB is there issue with leasing a local pool and providing aquatic therapy? Can a Hospital therapist provide in home therapy under part B?

    1. There are specific rules and regulations that must be followed when leasing a pool. The Medicare program does allow outpatient therapy to be provided in a patient’s home.