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Reports indicate SGR repeal coming — but for how long?

12/16/2013

Signs on Capitol Hill suggest that the sustainable growth rate (SGR) is marked for death — but will it be a lingering or a quick demise? One thing seems certain: There’ll be no draconian 20.1% cut to provider pay in 2014, and maybe none at all for years.

GPCI, practice expense, misvalued code changes to scramble your 2014 payments

12/16/2013

by: Scott Kraft

Regardless of how efforts to fix the looming cut to the 2014 Medicare physician fee schedule’s conversion factor end up, expect a series of other regulatory changes CMS enacted for 2014 to change your payments — in some cases significantly.

Clinical data registries open door to more appropriate specialty measures

12/16/2013

by: Scott Kraft

You may find it easier to participate in the Physician Quality Reporting System (PQRS) in 2014 now that CMS has finalized clinical data registries as a reporting mechanism to earn a 2014 bonus. The registries will allow specialties to have new, more specialty-relevant measures approved more quickly, which will mean better data for practices and CMS, experts tell Part B News.

How to use individual PQRS reporting to meet value-based modifier rules

12/16/2013

by: Karen Long

Your practice of 10 or more eligible professionals (EPs) could earn a 2% bonus under the value-based payment modifier if at least half of your EPs meet Physician Quality Reporting System (PQRS) requirements.

Some meaningful use deadlines delayed; critics worry about stage 2 readiness

12/16/2013

by: Roy Edroso

CMS plans to delay stage 3 meaningful use — but some health IT observers are disappointed that CMS isn’t going further and that providers won’t feel the benefits for a while.

Benchmark: E/M plus modifier 25 denials keep pace with E/M denials, 2011-2012

12/16/2013

by: Roy Edroso

Denials for E/M codes billed with modifier 25 (Significant, separately identifiable E/M service) went up as much as 3 percentage points in 2012 compared with 2011, according to CMS data.

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