What would you do if your Medicaid checks were replaced by IOU letters from your state? Practices in California are struggling to answer this question after the cash-strapped state issued more than $53 million worth of IOUs, including some to physician practices. If you can wait, however, you may earn an extra few percentage points on the money.

The table below shows the proposed impact on E/M services if CMS redistributes payments from consult services as outlined in the proposed 2010 fee schedule (see story).

You've got it in writing: CMS has forbidden carriers and Medicare Administrative Contractors (MACs) from deactivating your Medicare enrollment when you proactively report a practice location change outside of the 30-day window required by Medicare rules. The change came in Transmittal 295 to the Program Integrity Manual released June 26.

A new remittance advice code from CMS is intended to tell you that there is a discrepancy between the claims you submitted and the Medicare enrollment information on file for the referring physicians enrolled in Medicare.

CMS is convinced that once you try e-prescribing successfully, you'll like it so much you won't stop. The agency proposes to put its money where its mouth is, dramatically decreasing the minimum reporting requirements for you to earn an e-prescribing bonus in 2010.

The proposed Medicare 2010 Physician Fee Schedule rule is chock full of minor tweaks and changes to Medicare payment policy you need to know about to ensure you're able to budget and plan for 2010. Part B News has analyzed the entire rule and suggests you note these proposed changes.

After years of trying to modify and massage the consult billing rules into something that both CMS and the physician community could agree upon and properly bill, the agency now proposes to eliminate consult billing entirely in the 2010 Proposed Medicare Physician Fee Schedule, except for limited telehealth services (PBN 7/6/09). You would instead bill for new and established patient visits based on the site of the service.