Part B News | Part B News

10% conversion factor cut offsets E/M gains, with wild fluctuations on the horizon

12/14/2020

You’ll find a steep cut to the Medicare Part B conversion factor (CF) in 2021, in one part of a systemwide redistribution of the more than $100 billion in annual Part B provider payments. The CF falls 10.2% to a rate of $32.41 in 2021, down from $36.10 in 2020.

Simplify the visit complexity code: Forget specialty, focus on continuity

12/14/2020

by: Julia Kyles

You can earn an additional $16 for E/M office visits next year when the treating physician or other qualified health care professional acts as a “focal point of care.”

With HCPCS debut, take note of new rules for prolonged services

12/14/2020

by: Julia Kyles

You will count time in two ways if you report a prolonged service with an E/M office visit that is coded based on time next year. CMS calls CPT code 99417 — the add-on code for prolonged services — unclear and believes it can result in double-counting of time because the descriptor does not push far enough past the minimum time for the related office visit (99205 or 99215).

Telehealth expands even more, but will mostly go away unless Congress acts

12/14/2020

by: Roy Edroso

In the final rule, CMS cleared dozens of telehealth and telehealth-adjacent codes that nearly all providers can use right now. However, many of them are slated to be removed from general use after the COVID-19 public health emergency (PHE). A few codes, though, are exempt from the traditional telehealth rules.

APP debut, benchmark stasis, small changes mark QPP in PFS

12/14/2020

by: Roy Edroso

Aside from the delay of the MIPS Value Pathways (MVP) and the advance of the APM Performance Pathway (APP), the adjustments to the Quality Payment Program (QPP) and the Merit-Based Incentive Payment System (MIPS) do not veer too far from previous versions of the program. Yet experts warn that even minor changes can have a big impact on your performance.

Shared Savings gets routed into APP, but keeps Web Interface for one more year

12/14/2020

by: Roy Edroso

The Quality Payment Program (QPP) portion of the final 2021 Medicare physician fee schedule undergoes one major change — a new quality reporting method with both upsides and downsides — but participating accountable care organizations (ACO) get to hang onto the Web Interface option for one more year.

Fees and payment indicators complete the picture for new codes

12/14/2020

by: Julia Kyles

Take a look at the final payment determinations for codes that will go into effect Jan. 1, 2021. The list includes 39 codes that were previewed in the proposed 2021 Medicare physician fee schedule and four codes CMS created in the interim, including the replacement prolonged service code (G2212) and the extended virtual check-in code (G2252).

CMS finalizes MDPP changes; program all-virtual until the PHE ends

12/14/2020

by: Roy Edroso

Changes proposed to sustain the Medicare Diabetes Prevention Program (MDPP) as COVID-19 distancing makes in-person sessions problematic are implemented in the new physician fee schedule final rule — but note some rule changes for participants who start after Jan. 1, 2021.

2021 Part B fee projections: Top specialties adding – and losing – revenue

12/14/2020

by: Richard Scott

It’s a topsy-turvy fee outlook in 2021, as medical practices are projected to see wild fluctuations in Part B charges in the new year. With specialty-specific gains reaching as high as 16% – and losses also reaching double digits – your billing patterns are likely to tell how your Medicare charges will fare.

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.