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Category: MLN Articles

Multiple Procedure Payment Reduction (MPPR) on the Professional Component (PC) of Certain Diagnostic Imaging Procedures

From: CMS MLN Matters – MM9647; 8/5/16

Provider Action Needed

Change Request (CR) 9647 informs providers that Section 502(a)(2) of the Consolidated Appropriations Act of 2016 revised the Multiple Procedure Payment Reduction (MPPR) for the Professional Component (PC) of the second and subsequent procedures from 25 percent to 5 percent of the physician fee schedule amount. Make sure that your billing staffs are aware of these changes.

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Inpatient Rehab Facility PPS Annual Update for Pricer Changes – FY2017

From: CMS MLN Matters – MM9669; 8/5/16

Provider Action Needed

Change Request (CR) 9669 provides updated rates used to pay IRF PPS claims for FY 2017. A new IRF PRICER software package will be released prior to October 1, 2016, and will contain the updated rates that are effective for claims with discharges that fall within October 1, 2016, through September 30, 2017. Make sure your billing staff is aware of these changes.

PRICER Updated Rates – Eff October 1, 2016 – September 30, 2017

Standard Federal Rate $15,708
Adjusted Standard Federal Rate $15,399
Fixed Loss Amount $7,984
Labor-Related Share .709
Non-Labor Related Share .421
Urban National Avg CCR .421
Rural National Avg CCR .522
Low Income Patient (LIP) Adjustment .3177
Teaching Adjustment 1.0163
Rural Adjustment 1.149

Inpatient Rehab Facility PPS Annual Update for Pricer Changes – FY2017

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Update – IP Psych PPS – FY2017

From: CMS – MLN Matters – MM9732; 8/1/16

What You Need to Know

Change Request (CR) 9732 identifies changes required as part of the annual IPF PPS update from the FY 2017 IPF PPS Notice displayed on July 28, 2016. These changes are applicable to IPF discharges occurring from October 1, 2016, through September 30, 2017. In addition, CR9732 removes two ICD-10 PCS Electroconvulsive Therapy (ECT) codes, GZB1ZZZ and GZB3ZZZ, in accordance with Nation Coverage Determination (NCD) 160.25. Make sure your billing staffs are aware of these IPF PPS changes for FY 2017.

Update – IP Psych PPS – FY2017

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