CMS Announces Changes by Zip Code

The Center for Medicare Services (CMS) has announces changes to the list of urban and rural designations by zip code.  These changes are scheduled to become effective on January 1, 2015.  We have compacted this list down to those effected zip codes in Texas.  There are 32 Texas zip codes that are being changed from an urban designation to a rural designation.  On the opposing side, there are 63 Texas zip codes that are being changed from rural to urban.  You can see the list here.

Both of these designation changes have the potential of significant financial impact on those effected areas.  For those communities losing the rural designation, they will lose the bonus mileage money and could see a change to their locality multiplying factor that is used to determine reimbursement at each level of service.  Providers need to pay close attention to these changes and adjust their billing practices accordingly.

There is a significant push from within the industry to seek a delay in the implementation of the rural to urban changes.  The arguments being made involve requests to take specific considerations associated with a listed zip code into account so that CMS can assure this major adjustment is done in the most informed manner possible.

TEMSA will update information concerning this very important topic as is becomes available.