decisionhealth Newsletters, Coder Pink Sheets - 2018 Issue 3 (March)
Getting paid: Congress passes budget restoring GPCI floor and therapy cap exceptions
Subscribe or sign in to view the full article.
Article Overview
This article explains recently enacted budget legislation affecting Medicare payment policy and other federal health programs. It focuses on reinstated extender provisions, therapy payment exceptions and thresholds, payment methodology changes tied to Medicare quality programs, and the extension or funding changes for selected hospital and public health programs. The piece is relevant to coders, billers, therapy practices, and reimbursement professionals tracking Medicare policy updates and payment impact.
Why This Topic Matters
The legislation described affects reimbursement timing, payment calculations, and temporary policy extensions that can change how claims are processed and paid. Readers need this information to monitor Medicare payment environment changes and understand which programs and thresholds were extended or modified.
Article Sections
-
Medicare extender policies and payment restoration
Overview of the budget legislation and the Medicare payment policies that were restored after expiring at year-end. Covers the general payment impact on affected localities and practices.
-
Therapy cap exception process and threshold changes
Discusses the reinstated therapy exception framework, annual threshold updates, and related Medicare review processes. Also notes the affected therapy billing environment and CMS handling of claims during the lapse.
-
MIPS cost category flexibility
Summarizes language affecting the timing and flexibility of a cost category percentage within the Medicare quality payment program. Focuses on the policy change at a high level.
-
Other program extensions and funding changes
Covers additional expired programs that were extended and selected funding changes for other federal health initiatives. Includes broader budget-related items discussed at the end of the article.
What You Will Learn
- Which broad Medicare extender policies were restored by the new legislation
- How the article frames therapy payment exception and threshold updates
- What types of Medicare quality-payment program timing changes were included
- Which other federal health programs and funding items were affected
Who Should Read This
- Medical coders
- Medical billers
- Therapy practice managers
- Revenue cycle professionals
- Medicare reimbursement specialists
- Healthcare compliance staff
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com