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Important Updates: CMS Delays Rate Collapse and POS Data Accessibility


CMS Heeds Stakeholders’ Concerns on Rate Collapse

As part of recently announced changes to Medicare requirements, covered in our earlier blog, the Centers for Medicare & Medicaid Services proposed collapsing the current Medicare billing structure for Evaluation and Management Services from 5 levels to 2. Condensing the categories would have a particularly negative effect on specialists like rheumatologists, neurologists and internal medicine physicians who would have to accept reduced billing rates for complex and lengthy office visits.

CMS has now postponed this coding collapse for at least 2 years. More than 160 medical organizations, including the American Medical Association, protested this proposal. Their arguments cited that the coding change could create unintended consequences for specialists who treat the sickest patients and for primary care physicians. The Texas Medical Association was one of the healthcare groups and businesses that used the comment period to ask CMS to reconsider its proposal in view of the negative effects. 

POS File Now Available to the Public for Free

The Medicare Provider of Services (POS) database holds data on hospitals and other healthcare facilities. Collected through CMS regional offices and updated quarterly, the POS file contains information such as name and address of the facility along with the type of Medicare services provided. Each Medicare-approved provider has a separate record. 

Previously, this database had been available to the public only for a fee. However, as of now, the POS files are available as free downloads. You can find the most current 4 quarters and the December quarter files for each previous year on this CMS website

This is an important change as the data in the POS files is an invaluable resource to all stakeholders.

Let Us Manage All Your Payer Enrollment Services

If you require medical credentialing and payer enrollment needs for your practice or medical facility, please contact 1st Assistant. Our experienced and dedicated specialists will provide all credentialing and enrollment services quickly and will monitor your account for ongoing updates and re-attestations. Heidi Henderson, our company owner and President, is eager to meet you and discuss your payer enrollment needs. Please call us at 512.201.2668 or contact us via the website.

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