PDPM Operations: Selecting Primary Diagnosis

Driving PDPM Operations:  Selecting the Primary Diagnosis Under PDPM, the diagnosis coded on the 5-day/Initial Minimum Data Set (MDS) in section I0020B (primary reason for skilled stay) largely determines reimbursement for the entire Medicare stay, unless an Interim...

Medicare Final 2020 Physician Fee Schedule

Medicare Final 2020 Physician Fee Schedule (PFS) Released & Rule Includes Challenges for Part B Therapy Providers CMS released the final 2020 Medicare Physician Fee Schedule on November 1, 2019 which includes updates to payment policies, rates and quality...

Medicaid and the Optional State Assessment (OSA)

CMS Will Continue to Report RUG-III and RUG-IV HIPPS Codes, as Requested by the State, Until September 30, 2020 As of October 1, 2019, all scheduled PPS assessments (except the 5-day) and all unscheduled PPS assessments were retired. If you’re in a Medicaid case-mix...