Corporate Compliance

Transmittals and MLN Matters articles: CMS issues therapy cap values for CY 2013, instructs on claims-based data colelction for outpatient therapy services, and more

Medicare Insider, December 4, 2012

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CMS issues therapy cap values for CY 2013

On November 30, CMS issued a transmittal that describes the policy for outpatient therapy caps for CY 2013. This Recurring Update Notification can be found in chapter 5, section 10.

Effective date: January 1, 2013

Implementation date: January 7, 2013

View transmittal R2600CP.

CMS issues CY 2013 annual update for clinical lab fee schedule and lab services subject to reasonable charge payment

On November 30, CMS issued a transmittal that provides instructions for the CY 2013 clinical laboratory fee schedule, mapping for new codes for clinical laboratory tests, and updates for

laboratory costs subject to the reasonable charge payment.

Effective date: January 1, 2013

Implementation date: January 7, 2013

View transmittal R2601CP.

CMS replaces transmittal on implementation the claims-based data collection requirement for outpatient therapy services

On November 30, CMS replaced transmittal R2532CP, containing information on the implementation of the claims-based data collection requirement for outpatient therapy services – Section 3005(g) of the Middle Class Tax Relief and Jobs Creation Act (MCTRJCA) of 2012.

 View transmittal R2603CP.

CMS issues new place of service code for place of employment/worksite

On November 30, CMS issued a transmittal that creates a new place of service code for place of employment/worksite.

Effective date: April 1, 2013

Implementation date: April 1, 2013

View transmittal R2602CP.

CMS issues 2013 annual update to the therapy code list

On November 23, CMS issued a transmittal that updates the list of codes that sometimes or always describe therapy services.

Effective date: January 1, 2013

Implementation date: January 7, 2013

View transmittal R2596CP.        

CMS announces Medicare RHC and FQHC payment rates increases

On November 23, CMS issued a transmittal that provides instructions for the calendar year (CY) 2013 Payment Rate Increases for Rural Health Clinics (RHC) and Federally Qualified Health Centers (FQHC) services that can be found in Chapter 9, section 20 of the IOM.

Effective date: January 1, 2013

Implementation date: January 7, 2013

View transmittal R2595CP.

View MLN Matters article MM8119.

CMS issues revision to appeals section of Chapter 15, Program Integrity Manual

On November 23, CMS issued a transmittal that updates Pub. 100-08, Chapter 15, section 25 of this manual.

Effective/implementation date: December 24, 2012

View transmittal R440PI. 

CMS to retire Program Integrity management reporting system

On November 23, CMS issued a transmittal that notifies all Medicare contractors

and shared system maintainers that CMS will discontinue the direct reporting and collecting of medical review data to the PIMR. The system is being retired.

Effective date: April 1, 2013 (FISS and
MCS); July 1, 2013 (VMS)

Implementation date: April 1, 2013 (Implementation of FISS and

MCS); July 1, 2013 (Implementation of VMS)

View transmittal R441PI.

CMS replaces transmittal on annual type of service update

On November 23, CMS replaced transmittal R2570CP containing information on the crosswalk of 2013 HCPCS codes to national type of service (TOS) indicators.

View transmittal R2598CP.



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