Centers for Medicare and Medicaid Services (CMS)

Centers for Medicare and Medicaid Services (CMS)

CMS Final 2020 Payment Rules for Medicare MPFS and OPPS

Late Friday, November 1, the Centers for Medicare and Medicaid Services (CMS) posted the final 2020 payment rules for the Medicare Physician Fee Schedule (MPFS) and the Hospital Outpatient Prospective Payment System (OPPS). These rules contain proposed policy and payment changes under the Medicare program.   

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CODING AND REIMBURSEMENT | Auditory Function Evaluation and Computerized Dynamic Posturography: Codes and Payment Rates for 2020

In late 2018, the American Academy of Audiology, in collaboration with the American-Speech-Language-Hearing Association (ASHA), the American Academy of Neurology (AAN), and the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) surveyed the auditory function evaluation and computerized dynamic posturography codes at the request of the Centers for Medicare and Medicaid Services (CMS).  

A description of the new and revised codes follows: 

Topic(s): auditory function evaluation, computerized dynamic posturography, american academy of audiology, American Speech-Language-Hearing Association (ASHA), American Academy of Neurology (AAN), American Academy Otoringology-Head and Neck Surgery (AAO-HNS), Centers for Medicare and Medicaid Services (CMS), CPT - Current Procedural Terminology, Relative Value Update Committee (RUC), American Medical Association (AMA), Health Care Professionals Advisory Committee (HCPAC)

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COMPLIANCE | CMS Spotlight on Program Integrity and Provider Enrollment in Medicare, Medicaid, and CHIP

The Centers for Medicare and Medicaid Services (CMS) recently issued a final rule that provides more authority for CMS to address fraud, waste, and abuse in federal health insurance programs including Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP). The new rule aims to bolster the ability of CMS to fight fraudulent or other inappropriate activity before it happens and before providers are paid. 

Topic(s): Centers for Medicare and Medicaid Services (CMS), Medicare, Medicaid, Children's Health Insurance Program (CHIP), Office of General Inspector (OIG), secretary of health and human services, Provider Enrollment, Chain, and Ownership System (PECOS)

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Publication Issue: Audiology Today November/December 2019

Medicare Audiologist Access and Services Act of 2019 Introduced in the Senate

On September 9, 2019, U.S. Senators Elizabeth Warren (D-MA), Rand Paul (R-KY), Sherrod Brown (D-OH), and Roger F. Wicker (R-MS) introduced the Medicare Audiologist Access and Services Act of 2019 (S.2446).

Audiology Today Sept/Oct 2019…What’s Inside This Issue?

Take a look at the table of contents and delve into these online articles, which you can now easily search by topic, title, or author. 

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AUDIOLOGY ADVOCATE | Time to Activate to Advocate

With the 116th Congress already over a quarter under way, the Government Relations Committee (GRC) urges Academy members to get involved. It is an exciting time for audiology, with the Academy actively working and collaborating with other organizations on new policy initiatives. The audiology voice in numbers is critical for the profession in advancing these initiatives.

Topic(s): Advocacy, Patient care, Hearing, Hearing Aids, Hearing Loss, Healthcare, Medicare Audiologist Access and Services Act, Centers for Medicare and Medicaid Services (CMS), Medicare, Balance/Vestibular, Adult

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CODING AND REIMBURSEMENT | When and Why to Modify

Billing modifiers were created to provide additional information to the payer about the performed procedure(s) and help describe and/or qualify the services provided. There are common modifiers used by commercial payers and the Centers for Medicare and Medicaid Services (CMS), that indicate to the payer that the services provided have been altered in a way that is different than the ascribed definition of the billing code. For example, a modifier should be used when all of the tests in a bundled code were not performed or when only one ear was tested.

Topic(s): Centers for Medicare and Medicaid Services (CMS), Medicare, Advance Beneficiary Notice (ABN), CPT - Current Procedural Terminology, Coding, Reimbursement, Practice Management, Patient care, Treatment

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Our Responsibility to Move Audiology Forward

A culture of quality is needed if we are to bring audiology into the spotlight and highlight our expertise in hearing and balance. Ritz-Carlton co-founder and former president Horst Schulze states that we can create transactions every day, but until we place the person next to us as the most important person in the world in that moment, we will never create an experience.

Topic(s): Professional, Patient care, Public Awareness, Centers for Medicare and Medicaid Services (CMS), Coding, Reimbursement, Practice Management, Hearing Assistive Technologies (HAT), Balance/Vestibular, Hearing Aids, Hearing Health Care

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Publication Issue: Audiology Today September/October 2019

CMS Issues Proposed Payment Rules for 2020

Late Monday, July 29, 2019, the Centers for Medicare and Medicaid Services (CMS) posted the Proposed Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (OPPS) Rules for 2020. These comprehensive rules contain proposed policy and payment changes under the Medicare program.

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CODING AND REIMBURSEMENT | Potential Pitfalls in Cochlear-Implant Billing and Reimbursement

As cochlear implant awareness increases and more individuals receive cochlear implants, the demand for related audiological services is growing across the country. To meet this need, many audiologists have begun to add, or are considering adding, cochlear implant services to their practices. 

Topic(s): Coding, Reimbursement, Practice Management, Centers for Medicare and Medicaid Services (CMS), Medicare, Medicaid, Cochlear Implants (CI)

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Publication Issue: Audiology Today July/August 2019