decisionhealth Newsletters, Part B News - 2018 Issue 6 (June)
CMS reinstates outpatient hospital as eligible POS for exercise therapy program
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Article Overview
This article covers CMS revisions to guidance for the Medicare supervised exercise therapy program for patients with peripheral artery disease. It is aimed at medical coders, billers, and providers who need to understand the current billing guidance, eligible service locations, and the timing of when contractors begin accepting claims.
Why This Topic Matters
It matters because CMS changed and then revised its guidance in a short period of time, creating uncertainty about where the service can be reported. The article helps readers track the latest Medicare administrative direction affecting outpatient and office-based reporting.
Article Sections
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CMS updates to supervised exercise therapy billing guidance
This section summarizes the sequence of CMS guidance changes and the Medicare program timing. It focuses on the overall billing context and affected care setting types.
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Background on the MLN Matters guidance revisions
This section reviews the earlier MLN Matters release, the subsequent update, and the later reversal. It places the reporting issue in the context of CMS publication changes.
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Impact on providers and claim acceptance
This section discusses how the guidance affects providers and the start of claim acceptance by Medicare contractors. It addresses the practical relevance for offices and hospital outpatient settings.
What You Will Learn
- How CMS updated guidance for the supervised exercise therapy program
- Which broad care settings are discussed in the Medicare billing update
- Why the guidance changes created uncertainty for providers
- When Medicare contractors were set to begin accepting claims
Who Should Read This
- Medical coders
- Medical billers
- Cardiology practices
- Hospital outpatient departments
- Physician organizations
- Compliance staff
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