Contradictory Case Management Payment Methodologies: A Look at CMS, HCPCS, Procedure Coding, & More

OPEN MINDS The Behavioral Health & Social Service Industry Analyst

Solution Spotlight

It is difficult to disagree with the rationale the U.S. Department of Health and Human Services (HHS) Centers for Medicare and Medicaid Services (CMS) used in rescinding part of its Interim Final Rule (IFR) for case management and targeted case management released on June 30, 2009. Well, with one exception.

The provision concerning payment methodologies for case management services (§441.18(a)(8)(vi)) would have required that case management providers be paid at rates using . . .