Secrets to Successful New Technology Billing under Medicare’s OPPS and IPPS - On-Demand

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Secrets to Successful New Technology Billing under Medicare’s OPPS and IPPS - On-Demand

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Secrets to Successful New Technology Billing under Medicare’s OPPS and IPPS - On-Demand

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Available ON-DEMAND

Presented on: Thursday, January 30, 2020

Presented by: John Settlemyer, MBA, MHA, CPC, CHRI

In recent years, CMS has placed a heavy emphasis on an “unleashing innovation” campaign. That move toward innovation was apparent in both the 2020 Inpatient Prospective Payment System (IPPS) and Outpatient Prospective Payment System (OPPS) final rules, as the agency introduced policies that will expedite coverage approval for new technology procedures and devices.

CMS is also increasing add-on payments for certain new technologies, meaning additional reimbursement will be available for facilities providing these services. These regulatory changes will likely increase the amount of new technology services that facilities provide, and it is increasingly important that hospitals know how to properly code and bill for the growing number of new technology services to ensure hospitals are reimbursed properly in this high-dollar arena.

During this 90-minute webinar with live Q&A, John Settlemyer, MBA, MHA, CPC, CHRI, will walk attendees through the coding and billing processes for new technology in both inpatient and outpatient settings. This includes preemptively setting up charges for codes, capturing appropriate documentation, reporting all required billing information on claims, and creating postpayment audit processes to ensure facilities receive the expected reimbursement. Settlemyer will also break down the new guidance from CMS on what constitutes “substantial clinical improvement” and will review the lists of devices that qualify for new technology add-on payments.

At the conclusion of this program, participants will be able to:

  • Implement processes in both inpatient and outpatient settings to appropriately report and bill for new technology services
  • Describe changes to qualification criteria for new technology payments
  • Identify all information necessary to include on claims involving new technology
  • Create new technology auditing processes to ensure charge integrity and appropriate charge capture


  • Regulatory changes for 2020
    • Alternative pathways and substantial clinical improvement changes
    • Detailed overview of new policies in the 2020 OPPS and IPPS rules pertaining to new technology
  • Inpatient process for coding and billing for new technology
    • Documentation and HIM coding
    • Charge capture surveillance
    • Claims submission
  • Outpatient process for coding and billing for new technology
    • CDM setup
    • Charge integrity monitoring
  • Live Q&A


Who Should Listen?

  • Revenue cycle directors, managers, and staff
  • Revenue integrity directors, managers, and staff
  • Chargemaster maintenance professionals
  • Billing and reimbursement staff
  • Inpatient and outpatient coders
  • Compliance directors and managers
  • HIM directors, managers, and staff
  • Members of chargemaster committees

Meet the Speaker

John SettlemyerJohn Settlemyer is an adjunct instructor for HCPro’s Revenue Integrity and Chargemaster Boot Camp®. In addition, he is an assistant vice president, revenue cycle, with Atrium Health (formerly Carolinas HealthCare System) based in Charlotte, North Carolina. Settlemyer has 25 years in healthcare finance and reimbursement with Atrium Health, with focus in chargemaster (CDM) operations and compliance, charge capture, and revenue integrity, including oversight of the CDM for 40 hospitals and their associated care locations. He is a charter member and inaugural chairperson of The Provider Roundtable and also serves as an Advisory Board member for the National Association of Healthcare Revenue Integrity (NAHRI).

Continuing Education

This program has the prior approval of AAPC for 1.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Ability to claim credits for this webinar expires on: 1/29/21

This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

Ability to claim credits for this webinar expires on: 1/29/21

National Association of Healthcare Revenue Integrity (NAHRI)
This program has been approved for 1.5 continuing education units towards fulfilling the requirements of the Certification in Healthcare Revenue Integrity (CHRI), offered as a service of the National Association of Healthcare Revenue Integrity (NAHRI).


Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

No problem. The On-Demand version will be available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $259 value! 

Participation in the webinar is just $259 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email if you have questions.