CMS Publishes the Proposed 2021 IPPS Rule and New COVID Requirements


CMS has published the Proposed 2021 Inpatient Prospective Payment Payment Rule.  The deadline for comment is July 10, 2020.  The Proposed Rule contains a number of notable items including:

  • Proposed overall increase in IPPS payments of approximately 1.6%
  • Proposed reduction of hospital payments for excess re-admissions
  • ICD-10-CM update of nearly 500 new codes, 47 revised codes, and 58 deleted codes
  • Proposed new technology add-on payments for antimicrobial products
  • Proposed new MS-DRG for Chimeric Antigen Receptor (CAR) T-cell therapy

We recommend you read the complete Proposed Rule to understand the changes and potential impact to your facility.

The proposed rule can be accessed here:

CMS Fact Sheet:


CMS has established a new Level II HCPCS code C9803, for COVID-19 specimen collection under the Outpatient Prospective Payment System.  It is effective for services provided on or after March 1, 2020.  Any claims received on or after May 1, 2020 with the Coronavirus specimen collection codes G2023 or G2024 will be returned.

CMS is also requiring, as part of the CARES Act, that providers of diagnostic tests for COVID-19 post the cash price for a COVID-19 diagnostic test to their website starting March 27, 2020 through the end of the public health crisis.

HBE is available to assist with updating your charge description master, training of your providers and staff, policy revisions, auditing and other compliance and revenue cycle needs you may have.  We will continue to monitor these important developments.

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