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[DOI] [PubMed] [Google Scholar] 30.Papandreou I, Cairns RA, Fontana L, Lim AL, Denko NC

This code is particularly concerning because the coding structure of the family requires 7 units of add-on CPT code 15016 to be billed for the typical patient

Using the FY 2021 and FY 2022 MedPAR files, we currently estimate that for actual high cost outlier payments to have accounted for 7.975 percent of total LTCH PPS standard Federal payment rate payments in FY 2021 and FY 2022, the fixed-loss amounts would have needed to been set at approximately $47,550 and $60,650, respectively