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2021 list of fees for ‘selected procedures’ shows deep, steady cuts

08/24/2020

You won’t find many plus signs on the list of “selected procedures” that CMS released alongside the proposed 2021 Medicare physician fee schedule. Except for E/M services, reduced fees dominate.

Chorus of opposition builds against planned 2021 Medicare rate cuts

08/17/2020

by: Richard Scott

In the wake of CMS’ plan to cut the Medicare physician fee schedule conversion factor (CF) by 11% in 2021, a host of specialty societies and advocacy organizations are leading calls for federal intervention.

CMS keeps E/M coding, documentation update on track for 2021; payments mixed

08/17/2020

by: Richard Scott

You won’t find any deviations or sidesteps from the planned changes coming to the E/M office visit code set (99202-99215), after CMS confirmed them in the proposed 2021 Medicare physician fee schedule. That means you can mark your calendar now: The largest overhaul to E/M coding and documentation guidelines in 25 years will go live Jan. 1, 2021.

E/M overhaul will necessitate careful study, preparation, expert says

08/17/2020

by: Richard Scott

To understand the significance of the E/M updates contained within the proposed 2021 Medicare physician fee schedule, Part B News touched base with revenue cycle and practice management specialist Cathy Archuleta, CPC, manager with SunStone Consulting in Harrisburg, Pa.

QPP updates in 2021: Changes to measures, easier performance threshold, no MVP

08/17/2020

by: Roy Edroso

The Quality Payment Program (QPP) is slated to retrench slightly due to COVID-19, but take note of several big news items: You’ll find a new reporting scheme for MIPS Alternate Payment Models (APM), a smaller-than-expected rise in the overall performance threshold and several telehealth innovations.

Code and fee preview: Take a first look at the code changes coming your way in 2021

08/17/2020

by: Julia Kyles

Coders will have a small set of new procedure codes to juggle while they adjust to the new system for coding E/M office visits. Here are some highlights gleaned from the proposed 2021 Medicare physician fee schedule. See the chart, p. 10, for a preview of projected payments based on the proposed relative value units (RVU) and conversion factor.

New APM Pathway has downsides, and poor scores can mean a quick exit

08/17/2020

by: Roy Edroso

CMS is giving providers in the Shared Savings Program a potentially problematic new quality reporting mechanism and a two-strikes policy for underperformers.

In E/M watershed year, most specialties projected to take a reimbursement bath

08/17/2020

by: Roy Edroso

The extraordinary redistribution of allowable fees within the physician fee schedule is on pace to produce some crooked numbers in 2021. The payment outlook appears grim for a number of specialties whose reimbursement on top codes CMS proposes to reduce dramatically. Yet some specialties will still see gains.

CMS proposes 11% cut to 2021 conversion factor, confirms E/M coding overhaul

08/10/2020

by: DecisionHealth staff

You can expect to see wild swings to Medicare pay rates in 2021, according to proposals CMS released August 4. The agency announced a nearly 11% cut to the Medicare physician fee schedule’s conversion factor (CF), dropping it to a rate of $32.26 next year, down from $36.09 in 2020.

Accelerated payments coming due could pinch providers; feds slow about giving relief

08/10/2020

by: Roy Edroso

Some of the tens of billions of dollars in advance payments CMS used to help providers in the early days of the COVID-19 crisis are coming due, and though Congress has made some moves to address this they’re moving slowly. Major medical organizations are pushing them and CMS to act.

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