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The Centers for Medicare & Medicaid Services (CMS) has issued an important update through Change Request (CR) 13241, which becomes effective on January 1, 2023. This update is designed to enhance the accuracy and efficiency of payment processes for Home Health Agencies (HHAs) that do not submit the required quality data. The update fully replaces […]
The Centers for Medicare & Medicaid Services (CMS) has issued an important update, Change Request (CR) 13225, set to take effect on January 1, 2024. This update aims to enhance the accuracy and efficiency of processing home health (HH) claims. Here’s what you need to know: Removal of the Edit Bypass for Condition Code DR […]
The Centers for Medicare & Medicaid Services (CMS) has issued a new Change Request (CR) 13225, effective January 1, 2024, aimed at refining the processing of home health (HH) claims. This update focuses on improving the accuracy and efficiency of claims reporting condition code DR and handling admission source edits. Key Changes: Removal of Edit […]
Understanding the Competitive Bidding Program for Durable Medical Equipment (DME) The Competitive Bidding Program (CBP) for Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) is designed to improve the efficiency of Medicare payments for DME and ensure that beneficiaries have access to quality medical equipment at lower costs. The program encourages suppliers to submit […]
Reimbursement Changes Medicare Reimbursement Rate Adjustments: Background: Medicare periodically adjusts reimbursement rates for DME based on market data and competitive bidding outcomes. Recent Changes: Rates have been adjusted to reflect the savings achieved through competitive bidding, with reductions in payment rates for many items. Impact: Lower reimbursement rates can challenge the profitability of DME […]
Product Trends in Durable Medical Equipment (DME) The demand for durable medical equipment (DME) is being driven by several factors, including the rise in sleep disorders, respiratory diseases, and the growing preference for home-based care. Key products experiencing high demand include CPAP supplies, oxygen tanks, personal mobility devices, and home medical furniture. Let’s delve […]
