CMS Releases 2021 Final Outpatient Prospective Payment System/Ambulatory Surgical Center Rule On December 2, CMS finalized policy changes for the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) final rules. In this final rule, CMS will begin eliminating the inpatient only (IPO) list of 1,700 procedures for which Medicare will only pay when...

CMS Releases 2021 Final Physician Fee Schedule Rule On December 1, 2020, CMS finalized its Medicare Physician Fee Schedule Rule for the calendar year (CY) 2021. Office and Outpatient Evaluation and Management (E/M) Visits Last year, CMS finalized an important policy change in the 2020 Medicare Physician Fee Schedule Final Rule when it adopted CPT...

CMS Releases Proposed Rule on Durable Medical Equipment At the end of October, CMS proposed new changes to Medicare Durable Medical Equipment, Prosthetics, Orthotic Devices, and Supplies (DMEPOS) coverage and payment policies. This rule would provide more choices for beneficiaries with diabetes while streamlining the process for innovators in getting their technologies approved for coverage,...

Members of Congress Urge CMS Administrator to Not Apply Prior Authorization Requirements for Cervical Fusion On November 2, over 50 members of Congress sent a letter to CMS Administrator Seema Verma urging her to not extend prior authorization requirements for cervical fusion procedures performed in the outpatient and ambulatory surgical center settings. CMS had previously...