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Payment cuts are in the offing for Part B providers in 2023, along with a series of other projected changes targeting E/M services, COVID-related billing flexibilities and value-based care, according to the proposed 2023 Medicare physician fee schedule released July 7.
Juggling codes for observation and inpatient hospital services will soon be a thing of the past. The Jan. 1, 2023, update will shift facility visits, consults and home-based visits to a coding model based on medical decision-making (MDM) or time.
The legal consequences for providers and patients affected by the overturn of Roe v. Wade by the Supreme Court are still evolving, but experts warn that if those patients are in one of 10 states where abortion care is substantially illegal — even if the provider is not — doing more than consulting on the procedure can put providers in the crosshairs of state medical boards and law enforcement.
The next E/M update will affect 69 codes from five code families and will go live in less than six months. Part B News analysis of Medicare Part B claims for 2019 and 2020 reveals that frequently billed E/M services in three of the impacted code families — inpatient hospital, emergency department and nursing facility services — exceeded several office/other outpatient codes.


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