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Comprehensive Primary Care program misses spending mark but practices love it

06/11/2018

The Comprehensive Primary Care (CPC) initiative failed to substantially bend the Medicare spending curve, according to a new report. But leaders on the ground remain bullish about the value-based program, which they say has positioned their practices for long-term success.

Orthopedic practice scores a win in challenge to CCI code pairs

06/11/2018

by: Laura Evans

It doesn’t cost anything to ask for a correction if you find a possible Medicare coding error. And, as a Syracuse orthopedic practice discovered, you may end up reversing a troublesome code restriction that has been in effect for more than a decade.

Use higher pay, openness to outside experience to recruit non-clinical employees

06/11/2018

by: Roy Edroso

Recent evidence suggests good non-clinical practice employees — from receptionists, billers and coders to managers and department heads — have gotten harder to hire and keep and that you’ll have to spend money and look in new directions to do so.

AWV, IPPE denials stay high; initial AWV use, after a burst, falls

06/11/2018

by: Roy Edroso

Providers have seen no big break in the long tradition of high denials for both initial (G0438) and subsequent (G0439) annual wellness visits (AWVs), nor for the Welcome to Medicare visit (G0402; also known at the Initial Preventive Physical Examination or IPPE).

Medicare diabetes program starts slow, and pay hard to get — but may still be worth it

06/04/2018

by: Roy Edroso

Getting your pre-diabetic patients involved with the new Medicare Diabetes Prevention Program (MDPP) may be worth your while even if you have to foot the bill temporarily.

How to alter your physician compensation plans to meet your practice goals

06/04/2018

by: Roy Edroso

As physician compensation gets more varied – with metrics besides salary and productivity determining how much doctors get paid — you have more flexibility to shape your practice by rewarding behaviors you want to encourage.

Integrate behavioral health services, gain dollars: 5 tips for success

06/04/2018

by: Richard Scott

Adding behavioral health services as part of your routine care can be challenging, but CMS’ recent moves to facilitate behavioral health integration (BHI) among primary care and specialty practices give you a golden opportunity to expand your service offerings while bringing in more revenue.

CMS reinstates outpatient hospital as eligible POS for exercise therapy program

06/04/2018

by: Richard Scott

Despite short-lived guidance to the contrary, providers who work in a hospital outpatient setting will be eligible to report supervised exercise therapy (SET) services to patients with peripheral artery disease (PAD) when the new Medicare program commences July 2.

Per-capita E/M costs are $465 in Minot, N.D., but nearly $1,600 in Fort Lauderdale

06/04/2018

by: Richard Scott

Your location may determine how much money you earn through routine E/M encounters and, more generally, how patients receive their health care services, according to a Part B News analysis of recently released Medicare claims data.

Prove E/M services are unrelated to surgery to report during global period

05/21/2018

by: Richard Scott

Ensure you can prove that your patient encounters meet modifier 24 guidelines (Unrelated E/M service during a postoperative period) when reporting an E/M service during a patient’s global surgical period or you may be in the crosshairs of your Medicare administrative contractor (MAC).

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