Part B News Features
Question: We have a patient who sometimes brings gifts such as flowers or candy to his provider. The provider has shared with us that she finds this awkward and has asked him to stop, but the patien... More
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
CMS is proposing to significantly disrupt two key elements that feed into the valuation of Medicare professional service fees — indirect practice expenses and physician work relative value uni... More
Question: We have a patient who sometimes brings gifts such as flowers or candy to his provider. The provider has shared with us that she finds this awkward and has asked him to stop, but the patien... More
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
CMS is proposing to significantly disrupt two key elements that feed into the valuation of Medicare professional service fees — indirect practice expenses and physician work relative value uni... More
Tools
Help your staff prepare for the April 1, 2025, National Correct Coding Initiative update with the new, revised and deleted procedure-to-procedure (PTP) edits with short descriptors. 
Help your staff prepare for the April 1, 2025, National Correct Coding Initiative update with the new, revised and deleted medically unlikely edits (MUE) with short descriptors. 
Benchmark of the Week
CMS is proposing to significantly disrupt two key elements that feed into the valuation of Medicare professional service fees — indirect practice expenses and physician work relative value units (RVU) — and the results would send a shockwave through specialty providers’ expected payments depending on their site-of-service patterns.
Use of the modifier 78 (Unplanned return to the operating room by the same physician following initial procedure for a related procedure during the postoperative period) has been in steep decline in the past 10 years, falling from more than 531,000 claims in 2015 to 87,826 claims in 2020 and 51,177 in 2022. But in 2023, the most recent year for which Medicare data is available, there was a slight reversal.

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