Corporate Compliance

Note: CY2011 deductibles and coinsurance amounts, thoughts on physician supervision

Medicare Insider, November 23, 2010

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Editor’s note: Kimberly Hoy, Esq., director of Medicare and compliance for HCPro, Inc., is the author of this week’s note from the instructor.

This week, CMS published the transmittal with new manual sections implementing the new deductibles and co-insurance rates published in the Federal Register last week.

The inpatient deductible will increase from $1100 to $1132.  The daily coinsurance amount is ¼ of the deductible, or $283, for the coinsurance benefit days (day 61-90 of a benefit period).  The lifetime reserve day amount is ½ of the deductible, or $566, per lifetime reserve day (day 91-150 of a benefit period, if not already used in a prior benefit period).

The outpatient deductible, payable on outpatient services billed under part B, including hospital outpatient and physician services, was raised from $155 to $162 for CY2011.  This is the amount the beneficiary has to satisfy before the 20% co-insurance (or greater for some OPPS services) applies.

I also wanted to take a moment to discuss some of the changes to the physician supervision requirements for next year now that we have had some time to digest them a bit.  Debbie Mackaman did a nice review of the changes in her November 8th post.

Continue reading Kimberly's note on the MedicareMentor Blog.



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