Complexity of care add-on cleared for same-day preventive services
By: Julia Kyles, CPC
CMS finalized its proposal to relax restrictions on complexity of care add-on code G2211. The changes come in response to stakeholder concerns that the current CMS policy is disruptive to the way providers normally treat patients.
Batch of behavioral health services bolsters options, goes digital
By: Roy Edroso
The changes proposed in the final rule for Medicare’s burgeoning behavioral health category have been finalized, expanding its purview beyond previous therapeutic models and even into digital care engaged by the patients themselves.
CMS slow-rolls QPP/MIPS progress, with eye toward electronic reporting
By: Roy Edroso
The changes to the Quality Payment Program (QPP) and Merit-Based Incentive Payment System (MIPS) in the physician fee schedule final rule show CMS cautiously pushing forward into new forms of reporting and quantifying provider performance, with a focus on programs such as the Alternative Payment Model (APM) Performance Pathway (APP) Plus quality measure set and MIPS Value Pathways (MVP). The long-term hope is to achieve universal quality reporting for all patients regardless of payer.
Part B News Features
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Question: How should compliance leaders navigate the complexities of data sharing and interoperability initiatives while maintaining strict adherence to HIPAA regulations? ... More
NPP Report
Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More
Benchmark of the Week
You’ve read about the coming 2.8% pay cut that is on deck for 2025. However, a closer look at specific codes reveals that the impact of the cut will vary across services that are covered under... More
Ask a Part B News Expert
Question: How should compliance leaders navigate the complexities of data sharing and interoperability initiatives while maintaining strict adherence to HIPAA regulations? ... More
NPP Report
Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More
Benchmark of the Week
You’ve read about the coming 2.8% pay cut that is on deck for 2025. However, a closer look at specific codes reveals that the impact of the cut will vary across services that are covered under... More
choose your feature view ► Ask Part B News & NPP Report Benchmark of the Week & Ask Part B News NPP Report & Benchmark of the Week
Part B News Blog
Nov 1, 2024
Breaking: Fee cuts confirmed, behavioral health big focus in final 2025 PFS
by: DecisionHealth Staff
Oct 30, 2024
Same-day E/M service? Ensure your modifier 25 claims, documentation are good to go
by: DecisionHealth Staff
Oct 10, 2024
HHS issues RFI for Part D '$2 drugs' on some widely-used prescriptions
by: Roy Edroso
Tools
Train your team with the complete ICD-10-CM code set
Prepare members of your treatment and coding teams for changes to the diagnosis code set that will go into effect Oct. 1, 2024. Download and share the Excel file that contains five spreadsheets.
Give providers an illustrated guide to the new SDOH risk assessment code
Make sure your physicians and qualified health care professionals (QHP) are ready for their crucial role in reporting G0136 (Administration of a standardized, evidence-based Social Determinants of Health [SDOH] Risk Assessment tool, 5-15 minutes, not more often than every 6 months).
See more...
Benchmark of the Week
Conversion factor impact will vary for high utilization codes
You’ve read about the coming 2.8% pay cut that is on deck for 2025. However, a closer look at specific codes reveals that the impact of the cut will vary across services that are covered under the final 2025 Medicare physician fee schedule.
Social workers, psychology see RVU gains in 2025; a dozen are down
Take note of relative value unit (RVU) changes for specialty-specific services within the final 2025 Medicare physician fee schedule. The projected gains in allowable charges for select specialty groups in 2025 are led by clinical social workers (+4%), clinical psychologists (+3%) and anesthesiology providers (+2%), who will see the biggest RVU gains on net.
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