Hospital articles
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.
Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders
Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.
Hospital outpatient department (OPD) prior authorization (PA) exemption process reminders
Hospital outpatient departments that qualify for an exempt status effective January 1, need to have at least 10 claims submitted and finalized.
Inpatient hospital short stay reviews
Inpatient hospital short stay patient status reviews for acute care inpatient hospitals, long-term care hospitals, and inpatient psychiatric facilities.
Guidance on hospital inpatient admission decisions
In this special edition article, CMS stresses the importance of staying informed of all CMS national inpatient hospital policy and national and local coverage determinations regarding making a…
Part A outpatient infusion and hydration services
Read this article for important billing information for outpatient infusion and hydration services.
Inpatient admitted prior to entitlement
There are special billing guidelines to follow when the beneficiary becomes entitled to Part A benefits in the middle of an inpatient stay.
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.