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Understanding Basics of Alternative Payment Models (APMs)

Medisys Compliance

An Alternative Payment Model (APM) is a payment approach that gives added incentive payments to provide high-quality and cost-efficient care. CMMI considers APMs to be any arrangements whereby providers are held accountable for the quality and costs of care, not just paid based on the volume of services they deliver.

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Billing Guidelines for Medicare Home Infusion Therapy (HIT)

Medisys Compliance

If a patient receiving home infusion therapy is also under a home health plan of care and receives a visit that is unrelated to the administration of the home infusion drug, then payment for the home health visit would be covered under the Home Health Prospective Payment System (HH PPS) and billed on the home health claim.

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Revised Updates for Renal Dialysis Billing

Medisys Compliance

Proposed ESRD Payment System. This rule also proposes an update to the Acute Kidney Injury (AKI) dialysis payment rate for renal dialysis services furnished by ESRD facilities for calendar year (CY) 2023.