CMS: Claims will be processed with rates authorized by H.R.2

Confirms Extension of Therapy Cap Exceptions Process

From an email by CMS. Click image to download a PDF of the email.

From an email by CMS. Click the image to download a PDF of the email.

Medicare Administrative Contractors (MACs) have been instructed to implement the new payment rates in legislation passed just last night by the U.S. Senate, already passed by the U.S. House of Representatives two weeks ago, according to an email delivered today by CMS. While a small number of claims may have already been processed at the reduced rate (a 21% cut), MACs will automatically reprocess such claims with the new payment rate, with no action necessary by providers.

In the notice, CMS also confirmed the extension of other provisions, including the following:

  • Extended exceptions to the therapy cap,
  • Add-on payments for ambulance services,
  • payments for low-volume hospitals, and
  • payments for Medicare dependent hospitals.

As of 2pm ET, April 15, CMS has yet to update their pages about Inpatient Hospital Reviews or Therapy Cap, to reflect the changes under the new legislation.

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