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The CY20 OPPS Proposed Rule: A Response
The CY20 OPPS Proposed Rule contains additional information and requirements regarding hospital price transparency. Read our summary here!
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We analyze hospital prices at the procedure code level and present an analysis of suggested rate changes designed to enhance the defensibility of proposed pricing with sensitivity to financial impact.
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Check Out The Latest Hospital Finance News!
Wednesday, June 03, 2020
The 2021 Inpatient Prospective Payment Systems (IPPS) proposed
rule is out and as data nerds, we could not wait to dig into it and see what
changed. A comparison of Table 5 – listing of MS-DRGs and relative weights – is
a great place to start.
Quick refresher on terms:
Medicare
Severity-Diagnosis Related Group (MS-DRG) is a classification system for
inpatient discharges that helps standardize payment of services.Relative
Weight (RW) reflects the patient’s severity of illness and is a m...
Tuesday, April 28, 2020
COVID-19 has dramatically impacted the hospital industry. As hospitals adjust to new challenges, they must also face questions about new procedures and treatment requirements. Last week we took a close look at how hospitals are pricing COVID-19 lab tests. Now, let’s take a look at isolation rooms.
We sent out a survey to assess how hospitals were approaching this new pricing challenge. We received 40 responses.
Some of the questions focused on isolations rooms. These are not alwa...
Wednesday, April 22, 2020
COVID-19 has dramatically impacted the
hospital industry. As hospitals adjust to new challenges, they must also face
questions about new procedures and treatment requirements. In our next two blog
posts, we’ll take a close look at how hospitals are pricing COVID-19 lab tests
and isolations rooms.
We sent out a survey to assess how hospitals
were approaching this new pricing challenge and were pleased to receive 40
responses. In the midst of this
challenging time, we appreciate this ...
Thursday, April 16, 2020
Note: This post was updated on 4/16/20 to reflect the most current information.
During this COVID-19 pandemic, we have received several questions on how facilities should be billing for telehealth services. As we continue to collect as much information as possible, we wanted to provide our findings so far:
Payment Guidance:
Facility:Currently, billing for Medicare telehealth services is limited to professionals onlyHospitals are only eligible to bill for the originating site f...