White Paper

3 Pages
  • 3 Pages

D.C. Appeals Court Upholds CMS's Authority to Limit Payment for Services

 

E&M services limited at off-site provider-based locations.

The U.S. Court of Appeals for the District of Columbia recently upheld CMS's authority to broaden site-neutral payment reductions for evaluation and management services furnished at longstanding off-campus provider-based locations. CMS's new policy was quite important given that E&M services is about 50 percent of all separately payable or conditionally packaged services provided by outpatient departments every year. This white paper reviews the background of the ruling and discusses the appellate court arguments and rulings.