CMS Services

CODING, COVERAGE, AND PAYMENT

Customized protocols to support policy adherence of government programs

Health Insurance Policy brochureThe experienced team at 2SDAY International can helped you obtain the appropriate CPT and HCPCS insurance codes. We develop an action plan in securing reimbursement to introduce your new product to private insurers. The assignment or confirmation of the appropriate CPT or HCPCS code does not imply that the technology or service will be covered or reimbursed by CMS. Payer coverage policies have a major impact on product utilization and payment which directly influences dissemination and market uptake.

CMS policy and reimbursement services include:

  • Medicare and Medicaid policy review and research to determine coverage requirements
  • Discussions with Medicare contractors, medical directors, and Medicaid policy staff, to provide     decision makers with the data needed to implement appropriate coverage policies for client     products
  • Model coverage policy development for client products to support the payer policy development     process
  • Model the Affordable Care Act new payment platforms to align pricing strategy analysis for     coverage and payment
  • Average Sales Price (ASP) submissions support for pharmaceuticals and biologics to Medicare