Links
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2013 Final Rule
2012 Final Rule
- 2012 OPPS/ASC Final Rule
- 2012 IPPS Final Rule
- 2012 SNF Final Rule
- 2012 IRF Final Rule
- 2012 Hospice Final Rule
Centers for Medicare and Medicaid Services (CMS)
Payment Systems
- Ambulatory Surgical Center PPS
- End Stage Renal Disease PPS
- HIPPS: Inpatient Prospective Payment
- Home Health PPS
- HOPPS: Outpatient Prospective Payment
- Hospice Payment System
- Inpatient Psychiatric Facility PPS
- Inpatient Rehabilitation Facility PPS
- Skilled Nursing Facility PPS
Provider Types
- Hospital Information
- Conditions of Participation & Conditions for Coverage
- Ambulatory Surgery Centers
- Ambulance Services Center
- Critical Access Hospitals (CAH)
- Fee-For-Service Providers
- Home Health Agency Center
- Independent Diagnostic Testing Facilities
- Skilled Nursing Facility Center
- Independent Diagnostic Testing Facilities
- Long-Term Care Hospitals
The Health Insurance Portability & Accountability Act of 1996
- HIPPA
- Final Rule
- HIPAA Privacy Rule
- OCR – National Standards
- OCR – HITECH Breach Notification Interim Final Rule
- Security and Transactions Standards Modifications
Publications
- Ambulance Services Claims Processing Manual
- Ambulatory Surgery Centers Claims Processing Manual
- Drugs and Biologicals Claims Processing Manual
- Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Claims Processing Manual
- Home Health Agency Billing
- Hospice Claims Processing Manual
- Hospital Part A Manual
- Hospital Part B Manual
- Hospital Part B Outpatient Rehab and CORF/OPT Services
- Independent Diagnostic Testing Facility (IDTF) Claims Processing Manual
- Laboratory Services Claims Processing Manual
- Outpatient ESRD Hospital, Independent Facility, and Physician/Supplier Claims Processing Manual
- Physicians/NonPhysician Practitioner Claims Processing Manual
- Preventive and Screening Services Claims Processing Manual
- Program Memorandums & Transmittals
- Radiology Services and Other Diagnostic Procedures Claims Processing Manual
- Rural Health Clinics/ FQHC
- Skilled Nursing Facility Part B Billing (Including Inpatient Part B and Outpatient Fee Schedule Manual
- Skilled Nursing Facility Inpatient Part A Billing and SNF Consolidated Billing Manual
CMS Guidance for Routine Nursing Services
- Benefit Policy Manual – Chapter 1/Section 1 & Section 20
- Benefit Policy Manual – Chapter 6/ Section 20.5.1
- CFR 412/2 – (c) Inpatient Operating Costs
- CFR 413.53 – (b) Definition Routine Services
Services
- Physician E/M Documentation Guidelines
- Physician Information
- Physician Fee Schedule
- Advisory Opinions
Medical Policy
Billing
Provider Updates and Resources
Government Resources
- Balanced Budget Act of 1997
- Federal Register
- Food & Drug Administration
- GPO Access A to Z On-Line Resources
- Regulations Gov
- Social Security Act – Table of Contents
- Title 42 Code of Federal Regulations (CFR)
- Title 42 United States Code (USC)
- Department of Justice (DOJ)
- Office of Inspector General (OIG)
- Fraud Enforcement
- Corporate Integrity Agreements
- Alerts/Bulletins/Other Guidance
Compliance
- JCAHO – Patient Rights
- IRS Revenue Ruling 97-21
- American College of Healthcare Executives – Code of Ethics
- Best Compliance Practices – Vendor Relations
- Standards of Ethical Conduct – Executive Branch
- CAP – Compliance Program
- HcPRO – Compliance Monitor Archive
EMTALA
Hospital Standards
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Fiscal Intermediaries
- Arkansas Medicare Services
- BCBS of Alabama
- BCBS of Arizona
- Cahaba Government Benefit Administrators
- Highmark Medicare Services
- Cigna HealthCare Medicare Administration
- First Coast Service Options
- Georgia Medicare Part A
- Kansas Medicare
- Noridian Administrative Services
- Palmetto GBA
- Regence BCBS
- Rhode Island Medicare
- TrailBlazer Health Enterprises, LLC
- National Government Services, Inc.
