CMS releases new and updated tips on billing for various services


Medical bill

On February 22, 2018, the Centers for Medicare & Medicaid Services (CMS) released several new and revised provider compliance tip sheets as part of its monthly update to the Medicare Learning Network (MLN) homepage. The new and revised tip sheets detail the general requirements for coverage and the documentation required to submit claims for hospital beds and accessoriesblood count laboratory tests and diabetic test strips. The tip sheets also list common reasons for denials of claims and give advice for avoiding such denials. Links to other helpful resources regarding each specific subject are also included.   

The monthly update to the MLN page also includes an article on acute-care hospitals providing outpatient services to beneficiaries who are inpatients of Long Term Care Hospitals (LTCHs), Inpatient Rehabilitation Facilities (IRFs), Inpatient Psychiatric Facilities (IPFs) and Critical Access Hospitals (CAHs).  In the article, CMS clarifies its position that it generally will not pay an acute-care hospital for such services when the beneficiary is still an inpatient at another facility. CMS recommends that acute-care hospitals, under arrangements with an inpatient provider, charge the provider for payment for the outpatient services. 

Bricker & Eckler has extensive experience assisting health care providers with billing and compliance issues.  For assistance, please contact the authors or any member of the health care team. 

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