On January 14, 2021, CMS finalized a regulatory definition for determining whether an item or service is "reasonable and necessary" for Medicare coverage purposes. Medicare Program; Medicare Coverage ...

CMS issued a final rule Jan. 12 that updates the agency’s definition of “reasonable and necessary” coverage for services that fall under Medicare Parts A and B. The agency said codifying the ...

WASHINGTON The Centers for Medicare & Medicaid Services today issued a revised definition of multiple-source drugs to be reimbursed under its new payment formula for Medicaid prescriptions, even while ...

The Centers for Medicare and Medicaid Services released the long-awaited definition of "meaningful use" of healthcare information technology Wednesday, providing new guidance for providers and ...

The U.S. Centers for Medicare & Medicaid Services (CMS) has posted a proposed rule for coverage of FDA-designated breakthrough devices, a programmatic objective that has been front and center for the ...

The Centers for Medicare & Medicare Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) encourage public comment on two regulations issued today that lay ...

As of January 1, 2026, the CMS MDS 3.0 Quality Measures User’s Manual v18.0 introduced expanded definitions of falls, including intercepted falls and injuries previously excluded, fundamentally ...

The following Q&A comes from the Centers for Medicare & Medicaid Services website. Q: What is the updated definition of “new patient” for billing evaluation and management (E/M) services? A: Interpret ...

CMS' Medicaid managed care proposal broadens the definition of "care coordination," according to healthcare advocates in New Jersey, where the state's Medicaid program has been under fire. Across the ...

CMS explains that it is proposing to establish in regulations the factors it has historically used in making "reasonable and necessary" determinations under Section 1862(a)(1)(A), with "some ...