decisionhealth Newsletters, Part B News - 2013 Issue 12 (December)
Online only: CMS finalizes changes to therapy cap, screening tests, Physician Compare
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Article Overview
This article reviews a set of CMS final rule changes for 2014 that affect Medicare coverage, reporting, and payment administration across multiple settings. It is useful for billing staff, compliance teams, therapists, physicians, ACO participants, and other practice leaders who need a high-level view of policy updates involving therapy services, screening tests, Physician Compare, and related data collection initiatives.
Why This Topic Matters
The changes discussed affect how practices, hospitals, and reporting groups prepare for 2014 Medicare participation. Understanding the scope of these updates helps organizations identify which operational and reporting processes may need attention.
Article Sections
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Therapy cap extended to critical access hospitals
Discusses a CMS policy update affecting therapy services furnished in critical access hospitals and related Medicare administrative requirements for 2014.
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Abdominal aortic aneurysm ultrasound screening coverage changes
Summarizes changes to Medicare coverage criteria for a preventive screening test and the types of beneficiaries involved.
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More providers can order colorectal cancer screening fecal occult blood tests
Explains CMS changes expanding which practitioners may order a preventive screening test and the access rationale behind the update.
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Physician Compare expansion approved despite provider concerns
Covers CMS plans for collecting and publishing provider performance and patient experience data on the Physician Compare site.
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No new multiple procedure policies, but four codes added
Notes a Medicare payment policy update affecting a small set of therapy-related procedure codes and a deleted code for 2014.
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Approach for off-campus, provider-based hospital department data collection not finalized
Describes CMS consideration of methods for collecting data on services furnished in acquired practices and billed as hospital outpatient services.
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ACO reporting of shared savings
Summarizes ACO reporting requirements tied to shared savings participation and the CMS web interface.
What You Will Learn
- Which Medicare policy areas CMS updated for 2014
- How the article frames changes affecting therapy, screening, reporting, and data collection
- What operational topics are highlighted for practices and organizations
- Which general reporting and payment programs are discussed
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Physician practice administrators
- Therapy providers
- Hospital outpatient and revenue cycle teams
- Accountable care organization participants
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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