High-dollar and high-volume services are guaranteed to top the list of targets recovery audit contractors (RACs) will look for, experts say. That makes physical therapy (PT) a particularly obvious target for RACs once the permanent program goes live sometime this summer.

This chart shows how Medicare payments for ten codes commonly billed by non-physician practitioners (NPPs) will change if the proposed 2010 Physician Fee Schedule is implemented.

A non-physician practitioner (NPP) cannot inject his own opinions or observations when scribing for a physician, or your practice risks violating Medicare's rules for documenting a service.

Few changes in the proposed 2010 Medicare Physician Fee Schedule specifically mention non-physician practitioners (NPPs) - except a stinging pay cut for chiropractors, according to an NPP Report analysis. 

This week's question was answered with the assistance of Margie Scalley Vaught, CPC, Coding Content Specialist for DecisionHealth.

Q. Is a family practice doctor allowed to bill 92250 (fundus photography, $65.28) with a medical necessity diagnosis?

Medicare dollars set aside for treating illegal aliens have been exhausted in ten states, one of which shares a direct border with Mexico.

The ten Physician Quality Reporting Initiative (PQRI) measures listed below had the highest acceptance rates in 2007, according to a CMS report.

Imagine if the Medicare Payment Advisory Commission (MedPAC) was suddenly able to set the payments you get under the physician fee schedule and control coverage policies through transmittals - gaining powers now held by both Congress and CMS.

Successfully participating in the Physician Quality Reporting Initiative (PQRI) will get your provider's name on a list available to the public on Medicare's website. The public disclosure is not optional and that's got physician advocates worried.