As part of its ongoing efforts to increase access to care and to reduce unnecessary administrative burden for stakeholders, the Centers for Medicare & Medicaid Services (CMS) will be discontinuing the use of Certificates of Medical Necessity (CMNs) and Durable Medical Equipment (DME) Information Forms (DIFs) for claims with dates of service on or after Jan. 1, 2023.
“The report found: For 72% of inappropriate claims, DME suppliers failed to correctly code the SNF as a facility. Instead, they coded the place of service as the beneficiary’s home, thus enabling the claims to bypass the edit that rejects separate payment for most DME provided at facilities. By definition, SNFs provide primarily skilled care […]
“Medicare reimbursement rates for home medical equipment cover just 88 percent of overall costs for companies providing this service, raising concerns about the future viability of the home medical equipment industry under the current Medicare model, according to an American Association for Homecare study. The report’s conclusions show the current Medicare competitive bidding program for […]