decisionhealth Newsletters, Coder Pink Sheets - 2008 Issue 7 (July)
Medicare fee fix possible during 10-day claims hold
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Article Overview
This article explains a short-term Medicare claims payment hold connected to congressional delay on a physician pay-fix measure and summarizes CMS’s proposed physician fee schedule for 2009. It is relevant to physicians, practice managers, billers, coders, and reimbursement staff who track Medicare payment timing, physician fee updates, PQRI changes, diagnostic testing standards, and telehealth billing policy. The article also notes the CMS rulemaking timeline, the Federal Register publication, the public comment period, and the expected effective date of the final fee schedule.
Why This Topic Matters
It helps healthcare billing and reimbursement professionals understand when Medicare claims may be delayed and what broader Medicare payment policy changes CMS is proposing for the next year.
Article Sections
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Medicare claims hold and physician pay-fix delay
Summarizes the temporary delay in Medicare claims processing related to congressional inaction on physician payment legislation. It explains the timing of the hold and the general impact on payments for services during the affected period.
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Proposed 2009 Medicare physician fee schedule
Introduces CMS’s proposed physician fee schedule for the following year and outlines the broader payment policy context. It addresses proposed fee schedule changes and the rulemaking timeline.
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Services under review and proposed policy changes
Describes the categories of services and provisions CMS says it is reviewing in the proposed rule. It also notes proposed changes affecting diagnostic testing, quality reporting, and telehealth.
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Publication, comment period, and final rule timing
Summarizes the administrative steps following release of the proposed rule. It covers Federal Register publication, the comment period, and the anticipated timing of the final fee schedule.
What You Will Learn
- How a temporary Medicare claims hold can affect payment timing
- What CMS included in its proposed physician fee schedule for the next year
- Which broad policy areas CMS said it is reviewing in the proposed rule
- How the Medicare physician fee schedule rulemaking timeline proceeds
Who Should Read This
- Physicians
- Medical practice managers
- Medical billers
- Medical coders
- Reimbursement specialists
- Compliance staff
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