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CMS’ push for ‘equity’ won’t change providers’ lives today, but may soon

08/02/2021

The term “health equity” is turning up frequently in CMS rulemaking. Its impact is mostly seen far upstream of medical practice work, but experts see a growing role for it in the value-based future, where equitable health treatment can pay off for both patients and providers

CMS plans tougher critical care rules along with new split/shared policy

08/02/2021

by: Julia Kyles, CPC

If you enjoyed the twists and turns of CMS’ proposed split/shared policy, don’t miss similar turbulence in the proposed guidelines for critical care services (99291-99292) that also are part of the proposed 2022 Medicare physician fee schedule.

Enrollment fee may disappear as CMS nudges diabetes prevention, nutrition therapy services

08/02/2021

by: Roy Edroso

CMS is showing interest in shoring up the underutilized Medicare Diabetes Prevention Program (MDPP) and medical nutrition therapy (MNT) services in the proposed 2022 Medicare physician fee schedule.

Take a first peek at dozens of new codes slated to appear in 2022

08/02/2021

by: Julia Kyles, CPC

You’ll see dozens of new and revised codes in your 2022 CPT manual, according to a preview of the annual code updates contained in the proposed 2022 Medicare physician fee schedule released July 13.

Projected payments for new procedures and visits in 2022

08/02/2021

by: Julia Kyles, CPC

Take a look at the national payment for the new codes that will be paid under the Medicare physician fee schedule in 2022, in the non-facility (Non-Fac.) and facility (Fac.) settings, according to the proposed rule. Payments were calculated using the relative value units (RVU) in Addendum B to the proposed physician fee schedule and the proposed $33.5848 conversion factor.

Proposed cuts hit 38 of 40 high-utilization procedures, visits in CY2022

08/02/2021

by: Roy Edroso

Last year saw plenty of double-digit cuts in the “selected procedures” that CMS traditionally calls out to show the impact of the proposed physician fee schedule (PFS) on a suite of Medicare’s most frequently used codes.

CMS designs drastic changes to its split/shared policy

07/26/2021

by: Julia Kyles, CPC

Take careful notice of CMS’ proposed split/shared visit policy if your practice’s physicians and qualified health care professionals (QHP) regularly team up for hospital visits. CMS’ plans for split/shared visits in 2022 bear little resemblance to the original policy.

CMS proposes a 4% rate cut; opposition gets vocal

07/26/2021

by: Richard Scott

It didn’t take long for critics to lambast the proposed 3.75% reduction to the conversion factor after CMS announced its rate-setting plans July 13.

Digital access: CMS will allow mental health patients to stay online, mulls extensions

07/26/2021

by: Roy Edroso

CMS may keep at least some of the codes it allowed for telehealth during the public health emergency (PHE) through the end of 2023, and patients receiving mental health services via telehealth will be eligible for the digital services longer than that.

Big lift before MVP transition, with fewer quality measures, higher threshold

07/26/2021

by: Roy Edroso

Your practice may be relieved that the debut of the new MIPS Value Pathways (MVP) model for the Quality Payment Program/Merit-Based Incentive Payment System (QPP/MIPS) has been pushed back again in the proposed 2022 Medicare physician fee schedule. But don’t relax too much: A massive 15-point lift in the MIPS performance threshold will make the last year of the current MIPS structure challenging anyway.

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