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Medicare Changes to the 3-Day Payment Window Rule Impact Physician Billing in 2012

Posted on November 8, 2011 in Health Law News

Published by: Hall Render

On November 1, 2011, the Centers for Medicare and Medicaid Services (CMS) issued its Calendar Year (CY) 2012 Medicare Physician Fee Schedule Final Rule (Final Rule) finalizing proposed changes that impact physician billing for services subject to a billing policy commonly known as the 3-Day Payment Window Rule (or 1-Day Payment Window Rule for certain non-IPPS hospitals).  Earlier this year, in the Fiscal Year 2012 Inpatient Prospective Payment System (IPPS) Final Rule, CMS expanded the outpatient services that are subject to the 3-Day/1-Day Payment Window Rule (Payment Window Rule).  These changes were further discussed under proposed changes to the CY 2012 Medicare Physician Fee Schedule (MPFS).  (See Hall Render’s Health Law News article dated August 8, 2011: http://www.hallrender.com/library/articles/887/080811HLN.html).