As part of CMS’ quarterly update for 3rd Quarter 2020, the Agency announced retroactive changes to the Professional Liability Insurance (PLI) Relative Values (RVUs) for dozens of procedures paid under the Medicare Physician Fee Schedule. The PLI RVUs are one of the three components, the other two being “work” and “practice expense” of the Medicare...

ISASS sent the Center for Medicaid and Medicare Services a letter May 3, asking it to consider applying a C-code to the Barricaid Implant system. CMS C-codes are used for new technologies and new devices that are used in outpatient settings such as the Barricaid Implant system.  If approved, C-codes only apply to the facility...

In a letter dated April 16, 2019, ISASS asked for CMS to consider changes to a set of National Correct Coding Initiative (NCCI) edits for CPT codes 22842, Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in addition to code for primary...

The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule to update the Medicare inpatient rehabilitation facility (IRF) prospective payment system (PPS) for FY 2020. CMS projects that IRF PPS payments would rise by $195 million under the proposed rule. Specifically, CMS proposes a 2.5% increase factor, based on an IRF market...