In keeping with the practice of updating Medicare payment policies for IPPS hospitals and LTCHs on an annual basis, the CMS has unveiled a proposed rule for fiscal year (FY) 2024. The proposed rule for 2024 introduces changes to payment rates under both IPPS (Inpatient Prospective Payment System) and LTCH PPS (Long-Term Care Hospital Prospective Payment System) along with changes to Social Determinants of Health Diagnosis (SDOH) Codes, New COVID-19 Treatments Add-on Payment (NCTAP) etc.
This blog delves into the key changes as introduced in the CMS reimbursement proposal.
The new proposed rules by the CMS for FY 2024 hold significant implications for the healthcare industry. The proposed increment in payment rates for healthcare organizations under IPPS will enhance the quality of care, reporting, use of EHRs and ensure equitable reimbursement. At Invensis, we closely monitor medical billing trends, proposed rules and align these with our medical billing services to help practices meet CMS’s vision for FY 2024.
1. What does CMS reimbursement mean?
CMS reimbursement is the payment made by the Centers for Medicare & Medicaid Services (CMS) to healthcare providers for services rendered to Medicare and Medicaid beneficiaries. Reimbursement rates are determined based on CMS fee schedules and guidelines for covered medical procedures and services.
2. What does CMS stand for?
CMS stands for the Centers for Medicare & Medicaid Services. It is a federal agency within the U.S. Department of Health and Human Services responsible for administering Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the Health Insurance Marketplace. CMS oversees healthcare coverage and payment programs nationwide.
3. How do providers get reimbursed by Medicare?
Healthcare service Providers get reimbursed by Medicare through a process that involves submitting claims for services rendered to Medicare beneficiaries. Medicare reviews these claims, verifies eligibility, applies reimbursement rates based on fee schedules, and processes payments directly to healthcare providers or through intermediaries like Medicare Administrative Contractors (MACs).
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