Medicare Compliance & Reimbursement

Health care providers that bill Medicare for Part B mental health services should take special heed of a March 28 program memorandum from the Centers for Medicare & Medicaid Services (AB-03-037; http://cms.hhs.gov/manuals/pm_trans/AB03037.pdf). The memo is designed to help providers master the intricacies of mental health billing and documentation rules - an urgent compliance risk area highlighted in a number of recent reports from the HHS Office of Inspector General. In other recent program memoranda, CMS:
lays out an overview of the Medicare hospice benefit (AB-03-040; http://cms.hhs.gov/manuals/pm_trans/AB03040.pdf);
implements a temporary equalization of urban and rural standardized payment amounts under the inpatient prospective payment system (A-03-023; http://cms.hhs.gov/manuals/pm_trans/A03023.pdf);
details appeal procedures for "initial determinations" under Medicare Part A and Part B (AB-03-039; http://cms.hhs.gov/manuals/pm_trans/AB03039.pdf);
changes payment rates for rural health clinics and federally qualified health centers (A-03-021; http://cms.hhs.gov/manuals/pm_trans/A03021.pdf);
issues the April 2002 update to the hospital outpatient payment system (A-03-020; http://cms.hhs.gov/manuals/pm_trans/A03020.pdf);
revises outpatient code editor instructions for fiscal intermediaries (A-03-026; http://cms.hhs.gov/manuals/pm_trans/A03026.pdf);
announces the release date for version 29.0 of the provider statistical and reimbursement reporting system (A-03-022; http://cms.hhs.gov/manuals/pm_trans/A03022.pdf); and
clarifies how contractors should account for their benefit integrity workload (AB-03-038; http://cms.hhs.gov/manuals/pm_trans/AB03038.pdf).