Billing
Counting units for therapy codes
Read this article to learn how to count units to properly bill therapy HCPCS codes.
End-stage renal disease (ESRD) monthly capitation payment (MCP) claims
Billing ESRD monthly capitation payment claims correctly is important. Read this article to learn more about billing these claims.
What physicians need to know: home health patient-driven groupings model (PDGM)
In November 2018, the CMS finalized a new case-mix classification model, the PDGM, effective beginning January 1, 2020. The PDGM relies more heavily on clinical characteristics and other patient…
Long term care facility prospective payment system standard versus site neutral payment
For discharges on or after October 1, 2015, there are two separate payment categories for long term care hospital (LTCH) patients. This article provides those details.
Availability of the list of essential medicines considered to be in shortage for the purposes of the recently finalized separate IPPS payment for establishing and maintaining access to essential medicines
In the fiscal year 2025 IPPS and LTCH final rule, CMS finalized a separate payment for establishing and maintaining access to essential Medicines. Read this article to learn more.
Recommendations regarding the development of a model compliance plan for clinical laboratories
The Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of voluntarily developed and implemented compliance plans. The OIG has supplied guidance as to the…
Recommendations regarding the development of a model compliance plan for clinical laboratories
The Office of the Inspector General (OIG) and other federal agencies have emphasized the importance of voluntarily developed and implemented compliance plans. The OIG has supplied guidance as to the…
Skilled nursing facility sequential billing
Read this article to learn more about skilled nursing facility (SNF) sequential billing.
Skilled nursing facility (SNF) no-payment claims
Read this article to learn more about billing skilled nursing facility (SNF) no-pay claims.