Part B News | Part B News

CMS accepts the basics for hospital E/M updates, retains 3 home-grown policies

07/25/2022

You will continue to juggle two sets of rules for hospital inpatient and observation E/M visits if CMS sticks to plans outlined in the proposed 2023 Medicare physician fee schedule released July 7.

CMS tweaks telehealth rules as 151-day extension remains in place

07/25/2022

by: Julia Kyles, CPC

CMS will add its new prolonged service G codes to the telehealth services list, require modifier 93 for audio-only encounters and increase the originating site fee to $28.61, according to the proposed 2023 Medicare physician fee schedule.

Easing risk, CMS seeks to entice new entrants in Shared Savings program

07/25/2022

by: Roy Edroso

After some troubled years, the Medicare Shared Savings Program (MSSP) is hoping to reverse the trend by giving its members breaks on performance metrics. But CMS also is pushing hard for participants to come up to scratch quickly in two areas: the all-payer measurement model enabled by the electronic clinical quality measures (eCQM)/MIPS CQM reporting method; and health equity.

CMS proposes few changes to nursing facility code bundling, billing policies

07/25/2022

by: Laura Evans, CPC

CMS plans to adapt the new CPT guideline changes to the nursing facility (NF) codes into its Medicare policy structure next year.

CMS will accept ED coding and guideline update, keep referral policies

07/25/2022

by: Julia Kyles, CPC

CMS accepted the update to emergency department (ED) E/M visits (99281-99285) that the AMA released in early July, but don’t expect the agency to drop existing policies on same-day critical care and ED visits and how to report the services of an ED physician and a second physician who treat the same patient in the ED.

New model for MIPS is coming, while Advanced APMs get a tough break

07/25/2022

by: Roy Edroso

For CY 2023 changes to the Quality Payment Program (QPP) and Merit-based Incentive Payment System (MIPS), CMS focuses its attention on the MIPS Value Pathways (MVP), a new measures regimen that begins on a voluntary basis in 2023. A mandatory adoption deadline remains fluid.

Fee schedule round-up: Coding, billing, policy and regulatory changes

07/25/2022

by: DecisionHealth Staff

Don’t miss out on additional policy changes contained in the proposed 2023 Medicare physician fee schedule, from supply cost revisions to enrollment updates. Get the latest here.

2023 specialty impact: Winners and losers under the proposed PFS

07/25/2022

by: Richard Scott

As providers brace for a nearly 4% cut to the 2023 conversion factor, the impact of relative value unit (RVU) changes on specialties is projected to fluctuate from a 5% gain for infectious disease to a -4% drop for interventional radiology.

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