The federal No Surprises Act (NSA) prohibits out-of-network health care providers and facilities from balance billing commercially insured patients, in certain circumstances. The NSA and its implementing regulations set a method for determining the patient cost-sharing for these out-of-network situations, and when state law does not establish a provider payment methodology, the NSA establishes an…
Read MoreFor the public health emergency (PHE), CMS altered the definition of “direct supervision” to permit the presence and “immediate availability” of the supervising practitioner through “real-time audio and visual interactive telecommunications.” CMS will continue this policy through December 31, 2024 (it will also be extended to FQHCs and RHCs). (Reference Page, p. 167). Additionally, for…
Read MoreRemote Monitoring Services In the Final Rule, CMS provided a clarification on how remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) are addressed and billed. CMS clarified the following points: • After the PHE ends, RPM services are only for established patients. Patients who had received services during the PHE are considered established patients.…
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