Getting paid: CMS withdraws split/shared, critical care guidelines, but maintains coverage

Why This Topic Matters

The article matters because it addresses a temporary gap in CMS manual guidance for services that are still covered, creating uncertainty for documentation, coding, and claims review. It also highlights the shift toward future rulemaking and the practical need to track CMS, contractor, and regulatory updates.

Article Sections

1. CMS removes manual guidance but preserves service coverage

   Introduces the CMS manual changes affecting split/shared evaluation and management services and critical care services, and notes that coverage continues while new policy is developed.

2. CMS still covers the services

   Summarizes CMS statements about continued claims submission and the governing framework that still applies in the absence of detailed manual provisions.

3. Stay tuned for a proposed rule

   Describes the anticipated rulemaking process and the expectation that detailed agency policy will be issued later.