Many employees of hospitals do not understand how the Centers for Medicare and Medicaid Services (CMS) reimburse for outpatient physical, occupational, and speech therapy services provided by a hospital outpatient therapy department. Does CMS reimburse for these services under the Medicare Physician Fee Schedule (MPFS) or the Outpatient Prospective Payment System (OPPS)? In this article, I will answer the following questions:

On August 4, 2020, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2021 proposed rule titled “Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; New Categories for Hospital Outpatient Department Prior Authorization Process; Clinical Laboratory Fee Schedule: Laboratory Date of Service Policy; Overall Hospital Quality Star Rating Methodology; and Physician-owned Hospitals.“ Highlights of the proposed rule include: CMS is proposing to eliminate the Inpatient Only (IPO) list over a three-year transitional period with the list completely phased out by CY 2024 CMS is proposing to expand the

The Centers for Medicare and Medicaid Services (CMS) has published a revised edition of MLN Matters Number: MM11814 on July 16, 2020 that provides an update of the Hospital Outpatient Prospective Payment System (OPPS). This update contains information on the Telephone Services CPT codes (98966 – 98968) as well as the virtual check-in and E-Visit Level II HCPCS Codes (G2010, G2012, and G2061-G2063). Click HERE to access MM11814.