Guided by the MOON? Not a Good Idea

Article / Billing and Reimbursement / NAC

Since March 8, all hospitals and critical-access hospitals are required to issue the Medicare Outpatient Observation Notice (MOON) to fee-for-service Medicare and Medicare Advantage beneficiaries who receive observation services as outpatients for more than 24 hours. The MOON informs these patients that they are outpatients receiving observation services, not inpatients …

Bye-bye RUGs and OMRAs? Big changes in the works for SNF PPS

Billing and Reimbursement

The Centers for Medicare & Medicaid Services (CMS) has issued a precursor to a proposed rule that could lay the groundwork for retiring the existing case-mix classification model, the Resource Utilization Groups, Version 4 (RUG-IV), in the skilled nursing facility prospective payment system (SNF PPS). Switching to the Resident Classification …