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More specifically, application of the alternative performance payment limit would potentially reduce shared savings payments to outliers with sharp growth in beneficiary assignment during the agreement period despite benchmark year beneficiary assignments dropping below the current 5,000-beneficiary minimum, and as a result the program may see additional net savings to the Medicare Trust Funds as compared to the current policy
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In the CY 2022 PFS final rule, to address the need to establish a payment mechanism for synthetic skin substitutes in the physician office setting and to be responsive to feedback received from commenters, we finalized an approach for payment of each synthetic skin substitute for which we had received a HCPCS Level II coding application