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Make sure the MVP fits your clinicians, run traditional MIPS as a backup

08/14/2023

Participation in the Merit-Based Incentive Payment System Value Pathway (MVP) program gives providers another opportunity to meet their quality payment participation goals this year.

On MA prior auth, Congress proposes relief — but CMS is ahead of the game

08/14/2023

by: Roy Edroso

A couple of new bills — or rather, retreads of old bills — demonstrate increased congressional interest in reforming prior authorization (PA) under Medicare Advantage (MA). While the success of these bills is not assured, a recent proposed rule shows CMS is willing to move on this issue itself, with Congress serving more as a cheerleader than as a legal authority.

CMMI dementia model aims to aid unpaid caregivers, patients

08/14/2023

by: Roy Edroso

CMS is launching a demonstration model that is not only aimed at dementia patients, a growing segment of U.S. health care consumers, but also designed to help these patients’ unpaid at-home caregivers via care coordination and "respite services."

More coverage of the proposed PFS: Vaccine pricing, policy updates and more

08/14/2023

by: Roy Edroso

Don’t miss out on yet more policy changes contained in the proposed 2024 Medicare physician fee schedule, from vaccine payments to the never-used Appropriate Use criteria and more. Get all the latest here:

E/M fee preview: Care management service tops list with 26% pay jump

08/14/2023

by: Richard Scott and Laura Evans, CPC

A number of services in the E/M category are on track for big pay gains in CY 2024, led by behavioral health care management (99484), set for a 26% jump to $54 per service, and joined by two prolonged services codes (99415, 99416).

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