Hospital practices could lose revenue with proposed 3-day requirement

Article Overview

This article reviews a proposed Medicare payment change in the 2012 Physician Fee Schedule that could affect hospital-owned or hospital-controlled physician practices. It discusses the general payment impact, the role of facility versus non-facility pricing, the need for a new HCPCS modifier, and operational concerns for practices and hospitals around claims, communication, and potential overpayments. It is relevant to physician practices, hospital billing staff, compliance teams, and revenue cycle professionals tracking CMS policy changes.