Read more about the article Medicare Inpatient rehabilitation facility (IRF) Coverage
Inpatient rehabilitation facility and Medicare Coverage determinations

Medicare Inpatient rehabilitation facility (IRF) Coverage

Medicare Inpatient Rehabilitation Facility (IRF) Coverage Medicare Part A (Hospital Insurance) covers medically necessary care that insured patients receive in an inpatient rehabilitation facility or unit (‘ inpatient ‘rehab facility, IRF, acute care…

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Read more about the article Medicare Local Coverage Determinations Create Inconsistency in Medicare Coverage
Medicare administrative contractors (MACs) and the Centers for Medicare & Medicaid Services (CMS) sometimes develop policies to limit Medicare coverage of specific items and services. MACs issue local coverage determinations (LCDs) that limit coverage for a particular item or service in their jurisdictions only. This can lead to State-by-State variation in Medicare coverage for similar items and services.

Medicare Local Coverage Determinations Create Inconsistency in Medicare Coverage

Medicare Local Coverage Determinations (LCDs) are inconsistent and cause uneven access to care for Medicare beneficiaries based on arbitrarily geographic boundaries and jurisdictions, rather than on medical necessity. That is…

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Read more about the article Medicare Changes to Skilled Nursing PDPM in 2020
Annual Update of Healthcare Common Procedure Coding System (HCPCS) Codes for Skilled Nursing Facility (SNF) Consolidated Billing (CB) Update

Medicare Changes to Skilled Nursing PDPM in 2020

As of 2020, CMS has mandated that Skilled Nursing Facilities (SNFs) adopt the new Patient-Driven Payment Model (PDPM), certification surveys.  Additionally, SNFs must use the QAPI process.  QAPI is the…

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Dual Eligibles for Medicare, Medicaid come under fire

  Dual Eligibles for Medicare, Medicaid cost too much.   The administration that created the Patient Protection and Affordable Care Act with Medicaid expansion as a centerpiece to cover more low-income insureds…

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