Government Needs Entire Document Just To Fix Typos In Previous Document
Published Date: 1/13/2025
Rule
Summary
This update fixes small errors in a big Medicare and Medicaid rule that affects hospitals, outpatient centers, and tribal health services. It clarifies payment systems, quality reporting, safety standards for childbirth services, and special rules for people leaving jail. These changes take effect starting January 1, 2025, helping providers and patients get clearer, fairer care and payments.
Analyzed Economic Effects
5 provisions identified: 5 benefits, 0 costs, 0 mixed.
Skin cell autograft payment corrected
CMS assigned CPT code 15013 (skin cell suspension autograft preparation) and HCPCS code C8002 to APC 1532 (New Technology–Level 32) with a CY 2025 payment rate of $7,250.50 and status indicator "S", effective January 1, 2025. This replaces the prior assignment to APC 1567 and the lower $6,250.50 payment rate.
Multiple OPPS/ASC addenda payment fixes
CMS corrected multiple CY 2025 OPPS and ASC addenda items: device offset percentages (for example APC 5463 changed from 26.11% to 26.17%), duplicate or incorrect rows for several CPT codes were removed, certain brachytherapy and radiopharmaceutical payment rates were fixed, and CPT code 53865 was reassigned to the correct APC (5376) for CY 2025. These corrections apply beginning January 1, 2025.
CHIP continuous eligibility text clarified
CMS revised 42 CFR 457.342 to state that a State must provide continuous eligibility for children under a separate CHIP in accordance with Sec. 435.926 and related statutory provisions; this regulatory text is corrected and applicable beginning January 1, 2025. The provision addresses continuous eligibility for children in separate CHIP programs.
HCPCS C9734 remains active for CY2025
CMS clarified that HCPCS code C9734 will not be retired and will remain assigned to APC 5115 (Level 5 Musculoskeletal Procedures) for CY 2025; CMS will crosswalk C9734 claims data to set the payment for CPT code 5X008 (55882) for CY 2025. This correction is applicable beginning January 1, 2025.
Obstetrical staff training interval clarified
CMS corrected wording in the Conditions of Participation to replace "biannual/biannually" with "biennial/biennially," clarifying that required obstetrical staff training occurs every other year (biennially), not twice a year. This clarification is reflected in regulatory text and is applicable beginning January 1, 2025.
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