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Code of Federal Regulations (Last Updated: July 5, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter H - Health Care Infrastructure and Model Programs |
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Part 512 - Episode Payment Model |
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Subpart G - Waivers |
§ 512.615 - Waiver of certain post-operative billing restrictions.
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§ 512.615 Waiver of certain post-operative billing restrictions.
(a) Waiver to permit certain services to be billed separately during the 90-day post-operative global surgical period. CMS waives the billing requirements for global surgeries to allow the separate billing of certain post-discharge home visits described under § 512.600, including those related to recovery from the surgery, as described in paragraph (b) of this section, for episodes being tested in an EPM.
(b) Services to which the waiver applies. Up to the maximum post-discharge home visits for a specific EPM episode, as described in § 512.600(b)(5), including those related to recovery from the surgery, per EPM episode may be billed separately under Medicare Part B by the physician or non-physician practitioner, or by the participant hospital to which the physician or non-physician practitioner has reassigned his or her billing rights.
(c) Other requirements. All other Medicare rules for global surgery billing during the 90-day post-operative period continue to apply.