Why Providers Aren’t Happy with CMS’ Outpatient Medicare Physician Payment Proposal

Why Providers Aren’t Happy with CMS’ Outpatient Medicare Physician Payment Proposal

CMS proposed a 2.4% Medicare payment increase for hospitals’ outpatient departments and ambulatory surgery centers in 2026, along with a new two-tiered physician reimbursement structure based on participation in value-based care models. Provider groups are welcoming the short-term boosts, but they fear the changes don’t go far enough to address their long-term financial pressures. The post Why Providers Aren’t Happy with CMS’ Outpatient Medicare…

The Medicare Three-Day Payment Window Rule: Part IV – MedLearn Publishing

This week I am reviewing coding rules that impact inpatient claims when the Medicare Three-Day Payment Window results in ambulatory/outpatient surgery being paid as part of a subsequent inpatient admission. Most of these coding guidelines are located in Section II: Selection of the Principal Diagnosis, but that does not mean that these diagnoses can only be reported if they meet criteria to be the principal diagnosis. When a patient presents for…

Why Providers Aren’t Happy with CMS’ Outpatient Medicare Physician Payment Proposal – RamaOnHealthcare

CMS proposed a 2.4% Medicare payment increase for hospitals’ outpatient departments and ambulatory surgery centers in 2026, along with a new two-tiered physician reimbursement structure based on participation in value-based care models. Provider groups are welcoming the short-term boosts, but they fear the changes don’t go far enough to address their long-term financial pressures.The Centers [...]