Each year the Office of Inspector General (OIG) develops and publishes a work plan that describes “areas of interest” identified in the Medicare and Medicaid programs. The following describes some of the areas of physician services that are targeted for auditing and review this year. The entire OIG Work Plan is available at http://oig.hhs.gov/publications/workplan.asp.

The Centers for Medicare & Medicaid Services (CMS) will be reviewing place of service (POS) codes reported on Medicare claims for services performed in ambulatory surgical centers (ASCs) and hospital outpatient departments. The purpose of this focus review is to reduce payment errors when services are performed in a hospital outpatient department or ASC and reported with an incorrect POS. As you are aware, physician payment under the Medicare Resource-Based Relative Value Scale is lower when services are provided in facility settings because the practice expenses are incurred by the facility and not the physician....

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