Health Information Management

Hospitals to report nine-digit ZIP codes of outpatient service locations for certain services

APCs Insider, March 13, 2009

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On February 13, CMS issued a clarification for the calculation of payment amounts for services paid to hospitals on the basis of the Medicare Physician Fee Schedule (MPFS), such as physical therapy, occupational therapy, speech language pathology, and mammograms. The instruction requires providers to report the ZIP code of outpatient service facility locations for off-site outpatient facilities.

In Transmittal R1681CP, CMS explains that the change responds to changes in how hospitals provide outpatient services. Effective July 6, CMS will use the facility location's nine-digit ZIP code to calculate the appropriate local MPFS payment.

This article was adapted from the February 17 issue of the HCPro, Inc. e-newsletter Medicare Weekly Update.



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