Hospital OPPS - January 2020 Update - Revised

MLN Matters Number: MM11605 Revised
Related CR Release Date: February 4, 2020
Related Transmittal Number: R4513CP & R267BP
Related Change Request (CR) Number: 11605
Effective Date: January 1, 2020
Implementation Date: January 6, 2020

Note: CMS revised this article on February 4, 2020, due to an updated CR 11605. To reflect the updated CR in the article, CMS added Section 12.d. (Radiopharmaceuticals with Pass-Through Status as a Result of Division N, Title I, Subtitle A, Section 107(a) of the Further Consolidated Appropriations Act of 2020 (Public Law 116-94)) and Section 19 Extravascular Implantable Cardioverter Defibrillator (EV ICD). CMS renumbered existing Sections 12.d through 12.e. and changed Section 19 (Coverage Determinations) to Section 20. We also added Table 11 (Radiopharmaceuticals Receiving Pass-Through Status in Accordance with Public Law 116-94) and Table 14 (Extravascular Implantable Cardioverter Defibrillator (EV ICD) Effective January 1, 2020). CMS renumbered existing tables 11 through 13. The CR release date, transmittal numbers and link to the transmittals were also changed. All other information remains the same.

CR 11605 describes changes to and billing instructions for various payment policies that Medicare is implementing in the January 2020 Outpatient Prospective Payment System (OPPS) update. Make sure your billing staffs are aware of these changes

View the complete CMS Medicare Learning Network (MLN) Matters (MM)11605.

Last Updated Feb 05, 2020