12.18.09 – Medicare RAC for Region A, recently posted a new CMS approved audit issue for automated RAC review
DCS Healthcare (DCS), the Medicare recovery audit contractor (RAC) for Region A, recently posted a new CMS approved audit issue for automated RAC review on its website.
The new CMS approved audit issue is titled “Clinical Social Worker (CSW) Services” and applies to CSW providers in the states of Massachusetts, Maine, New Hampshire, Rhode Island and Vermont. On the DCS website, the new audit issue is described as:
- CSW services rendered during an inpatient acute care or skilled nursing facility stay are not separately payable under Medicare Part B, instead they are included in the facility’s Prospective Payment System (PPS) payment. CSW providers are expected to render services under arrangement with the facility. Therefore, an issue may exist when a beneficiary received CSW services during an inpatient stay, which have been billed and reimbursed under Medicare Part B.
Region A includes Connecticut, Delaware, District of Columbia, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont.
