Home | News & Analysis
Part B News
Follow CMS rule, not CPT guidance when you report modifier 99
03/03/2025
by: Julia Kyles, CPC
Train new coders to follow CMS’ rules when they find CPT guidance that doesn’t match Medicare’s requirements.
Bird flu, measles spread: If you’re nearby, take precautionary steps
03/03/2025
by: Roy Edroso
Flu season has a few distressing added wrinkles this year. Keep your eye on two disease outbreaks that have health officials on high alert in several parts of the country, and make sure your infection control is tight.
MACs finalize uniform LCD to limit sacroiliac fusions starting April 17
03/03/2025
by: Laura Evans, CPC
Practices in 22 states covered by three Medicare administrative contractors (MAC) should prepare for coverage to be halted in April for minimally invasive sacroiliac fusion procedures that do not include placement of transfixation devices across the joint.
Practices rolled with code revisions, saw slight uptick in denials
03/03/2025
by: Julia Kyles, CPC
Keep an eye on denials when you report a revised code even when your overall reporting of the service decreases. That’s one lesson to draw from Medicare Part B claims data for 2023, the latest data available.
Prevent harm to staff and patients — and your practice — with tight security
02/24/2025
by: Roy Edroso
Practice security is paramount not only for patients but also for staff. If they’re your first line of defense, they have considerable exposure if trouble walks in. It’s important to consider their safety, for legal as well as humanitarian reasons.
3 ransomware settlements underscore need for compliance vigilance
02/24/2025
by: Dom Nicastro
Ransomware threats in health care are growing. As a not-so-subtle reminder, consider three settlements from the Office for Civil Rights (OCR) occurring this past October. These enforcements mark the OCR’s fifth, sixth and seventh actions related to ransomware, and underscore the vital importance of proper cybersecurity safeguards.
PHE or no PHE, interstate telehealth remains a legal matter
02/24/2025
by: Roy Edroso
Question: With Medicare extending the telehealth flexibility for some items until March 31, 2025, do you know whether an Indiana physician can perform telehealth services on a patient living in Michigan or Florida for the winter? Or does the physician have to be licensed in that state? I know the geographical restrictions are lifted until March 31, but I wasn’t sure whether that includes the state licensing issue or if that requirement is at the individual state level.
Proposed guidance document: Study protocols that use real-world data
02/24/2025
by: Part B News staff
On January 17, CMS published a Proposed Guidance Document regarding study protocol that relies on real-world data (RWD) sources for a national coverage determination using the coverage with evidence development (CED) paradigm. 
Top-reported CCM code delivers 95% fee gain over two years
02/24/2025
by: Richard Scott
It’s been a bumper multi-year rate of growth for a series of chronic care management (CCM) codes, led by the standard bearer 99490, which saw payments nearly double between 2021 and 2023, topping $259 million in non-facility professional fees.
Medicare opt-outs minor, but concierge thrives as part of mixed models
02/17/2025
by: Roy Edroso
Though recent statistics show very few physicians opting out of Medicare, boosters of self-pay medical practice models — concierge, direct primary care and hybrid — still believe those models will advance in years to come, partly due to the interest of physicians, and partly due to the interest of investors.
Prev Next

Login

User Name:
Password:
Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Quick Links
Learning Opportunities
See more...
Forum

The Forum is temporarily unavailable.

click icon to expand
Back to top
Privacy Policy
|
Terms of Use
|
© 2025 DecisionHealth, a division of HCPro LLC