On July 31, CMS issued a final rule that updates Medicare payment policies and rates for facilities under the Inpatient Rehabilitation Facility (IRF) Prospective Payment System (PPS) and the IRF Quality Reporting Program for fiscal year 2020. CMS is continuing ts efforts toward the eventual transition to a unified post-acute care system through updates to the data used for IRF payments, including revising the Case-Mix Groups (CMGs), updating the CMG relative weights and average length of stay values, and using concurrent inpatient prospective payment system wage index data for the IRF PPS to align wage index data across settings of care. For fiscal year 2020, CMS is finalizing updates to the IRF PPS payment rates using the most recent data to reflect […]
Centers for Medicare and Medicaid Services Administrator Seema Verma has tasked her Patients Over Paperwork team with exploring what CMS can do to improve Prior Authorization (PA) burdens as part of the eighth topic addressed under the initiative. They are conducting many listening sessions with various stakeholders over the next few weeks, including a wide range of providers and health plans, to gather information on burdens and suggestions on what CMS can do on this issue. They are also visiting practices to observe the PA process in action. In this effort, CMS is looking for data on PA. They are particularly interested in the following data points in advance of taking meaningful action: Practice costs to complete PA tasks, particularly […]
This is in regard to the 2020 Medicare Physician Fee Schedule Proposed Rule, released by the Centers of Medicare and Medicaid Services (CMS) on July 29, 2019. Specifically, the proposed rule proposed a recommended work Relative Value Unit (RVU) of 9.03 of CPT code 27279, Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device. In the proposed rule, CMS indicated they were seeking comment on whether to adopt a work RVU of 20.00 which is the work RVU for CPT code 27280, Arthrodesis, open, sacroiliac joint, including obtaining bone graft, including instrumentation, when performed to achieve site-of-service parity and eliminate incentives for facilities to use a […]
Read the Summer 2019 issue of Vertebral Columns. In this issue: Medicare, Machine Learning & Artificial Intelligence in Spine Surgery, Maximizing Lordosis with MIS TLIF, Using Digital Media to Market Your Practice, Back Pain in Children & Adolescents, and Complex Regional Pain Syndrome!