Medicare Continues to Modernize Payment Software

This article informs providers about efforts by the Centers for Medicare & Medicaid Services (CMS) to modernize payment grouping and code editing software. A previous article, SE19013, provided initial information on this modernization. SE20019 informs providers that in October 2020, CMS will expand this modernization effort to include these additional software products: the IRF Case-Mix Group (CMG) Grouper and the IRF Pricer and PC Pricer. Note: A similar conversion for the SNF Patient Driven Payment Model (PDPM) Grouper is planned for October 2021.