Part B News | Part B News

Practices lob dire warnings to CMS ahead of planned cuts to cataract surgery

08/26/2019

Many providers and medical groups are expressing dismay at the rate cuts expected to hit two frequently billed codes for cataract surgery in 2020, warning that sharp pay declines could harm patient care and break the bank, particularly in rural areas.

Prepare to expand list of who can document the record, and who must verify

08/26/2019

by: James Dresbach

You’re on pace to find significant adjustments to the medical record documentation review and verification process heading into 2020, as CMS seeks to curtail work burden associated with its reigning documentation standards.

With physician suicide risk a real threat, beef up resources, wellness programs

08/26/2019

by: Roy Edroso

Added pressure in the lives of physicians leaves them uniquely vulnerable to suicide; some extra sensitivity and outreach may reduce the risk.

For E/M, initial NPP-only visit counts — unless there’s no professional service

08/26/2019

by: Roy Edroso

Question: A new patient came in and saw our physician assistant (PA) for some lacerations. She did not see a doctor. A week later the patient returned for follow up with an M.D. For purposes of billing the E/M, is the doctor visit a new patient visit or an established patient billing?

Coming cataract fees on track to drain millions from payment stream

08/26/2019

by: Richard Scott

Practices are expecting to take a hit on cataract surgery fees in 2020 based on pay rates announced in the proposed 2020 Medicare physician fee schedule, and that could lead to a drain of hundreds of millions of dollars nationally.

Payment fluctuations create big winners, losers among most-billed services

08/19/2019

by: Richard Scott

You’ll find reason to cheer the expected payments for frequently reported codes in 2020 if you conduct a steady stream of transitional care management (TCM), X-rays and other services. You may be less enthused if your bread-and-butter encounters involve vision testing or CT scanning.

CMS hopes eased reporting, new codes for care management will attract practices

08/19/2019

by: Julia Kyles

CMS believes that lots of work and low pay are making doctors avoid care management services, but it has a number of ideas designed to boost utilization.

MIPS to go MVP status in 2021, become simpler, more APM-friendly, rule says

08/19/2019

by: Roy Edroso

Perhaps the biggest news impacting your participation in the Quality Payment Program (QPP) doesn’t have to do with 2020 (PBN 8/12/19). The Pathways (MVP) version of the Merit-based Incentive Payment System (MIPS) is slated to launch in 2021 and offers sufficiently meaningful changes that you may expect some transitional bumps that year.

Codes cleared with TCM in PFS have nowhere to go but up

08/19/2019

by: Roy Edroso

If the codes CMS just cleared to be billed with transitional care management (TCM) in 2020 see a lift in utilization, you can be pretty confident that clearance will be the reason for the change. That's because, as you can see by this chart, utilization of these codes over the past five years has been very consistent — and mostly low — even when payment terms have been altered.

E/M in flux: Key documentation changes loom, payment boost anticipated

08/12/2019

by: Richard Scott

You’ll feel significant ramifications from the shaken-up orb of E/M coding after CMS tethered far-ranging documentation standards and potentially massive payment revisions to the AMA’s vision moving forward. The vast changes, set to arrive Jan. 1, 2021, could add billions of dollars to the national E/M revenue stream.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.