Reimbursement and Coding

This Medicare coding and payment guide offers information about reimbursement for pulmonary artery pressure long-term hemodynamic monitoring.

This document provides a Medicare coding and payment overview for remote monitoring by location.

This document delivers a current list of reimbursement Healthcare Procedural Coding System (HCPCS) Device Category C-codes

This printable form offers an easy CPT coding reference.

Download a sample letter template that provides suggestions to assist in writing a Letter of Medical Necessity or prior authorization request for CardioMEMS implant. Physicians should customize the letter based on the patient's medical history and diagnosis and to be consistent with any specific prior authorization requirements from the health plan.

Download a sample letter template that provides suggestions to assist in writing a Letter of Appeal of a denial of coverage for CardioMEMS implant procedures. Physicians should customize the letter based on the patient's medical history and diagnosis, and to be consistent with any specific appeal requirements from the health plan.

This webcast addresses the 2022 Medicare Payment Updates for the Inpatient Prospective Payment System (IPPS), Outpatient Prospective Payment System (OPPS), the Physician Fee Schedule (PFS), and coding and coverage for procedures supporting the CardioMEMS HF System implant and remote monitoring.

Provides Medicare guidance on coverage when the procedure is performed in a location other than a hospital.

This guide includes Medicare Physician Payment Rates for cardiovascular procedures. For more detailed information, please refer to the CY Physician Fee Schedule Final Rule on the CMS website.

This guide provides a summary of the Medicare Hospital Inpatient Prospective Payment System (IPPS). It includes information on the Readmission Reductions Program, Value Based Purchasing, and Hospital Inpatient Reimbursement Rates for select cardiovascular DRGs. For more detailed information, please refer to the FY IPPS Final Rule on the CMS website.

This guide provides a summary of the Medicare Hospital Outpatient Prospective Payment System (OPPS) Update. It includes updates to the Comprehensive APC Policy, Site Neutral Payments, Device Intensive Procedures, the Transitional Pass-Through Payment Policy, and Hospital Outpatient Reimbursement Rates for select cardiovascular APCs. For more detailed information, please refer to the CY OPPS Final Rule on the CMS website.

In the absence of a national coverage policy, an item or service may be covered at a local basis. Check here for a list of CMS policies that provide Medicare beneficiaries coverage in certain locations across the country.

Focusing on coverage, billing, and payment rules for specific provider types, these articles explain national Medicare policy in an easy-to-understand format.

Developed by CMS, the initiative promotes correct coding methodologies to control improper coding leading to inappropriate payment.