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In E/M watershed year, most specialties projected to take a reimbursement bath

08/17/2020

The extraordinary redistribution of allowable fees within the physician fee schedule is on pace to produce some crooked numbers in 2021. The payment outlook appears grim for a number of specialties whose reimbursement on top codes CMS proposes to reduce dramatically. Yet some specialties will still see gains.

CMS proposes 11% cut to 2021 conversion factor, confirms E/M coding overhaul

08/10/2020

by: DecisionHealth staff

You can expect to see wild swings to Medicare pay rates in 2021, according to proposals CMS released August 4. The agency announced a nearly 11% cut to the Medicare physician fee schedule’s conversion factor (CF), dropping it to a rate of $32.26 next year, down from $36.09 in 2020.

Accelerated payments coming due could pinch providers; feds slow about giving relief

08/10/2020

by: Roy Edroso

Some of the tens of billions of dollars in advance payments CMS used to help providers in the early days of the COVID-19 crisis are coming due, and though Congress has made some moves to address this they’re moving slowly. Major medical organizations are pushing them and CMS to act.

Use the fee schedule’s addendum B to winnow out procedures unsuited for the office

08/10/2020

by: Julia Kyles, CPC

Question: Do you know where we can find a list of procedures that are allowed in an office setting?

Lesion removal, blood draws top list of non-E/M codes in the office

08/10/2020

by: Richard Scott

Of the millions of procedures performed in place of service (POS) 11 (Office) every year, lesion-destruction services are some of the most frequently reported. Debriding nails and joint injections are other common non-E/M services.

How to craft provider contracts that deal with board sanctions — and protect the practice

08/03/2020

by: Roy Edroso

When setting up employment or partnership terms for providers, practices usually make some provision for medical board actions that would render the provider’s presence unsustainable. Experts say practices should pay attention to details that sometimes get missed — such as how to deal with sanctions that “encumber” providers without suspending their licenses, or what to do when a provider’s incapacity is related to a disability.

Pandemic labor updates: DOL offers new COVID guidance on FLSA, FMLA, FFCRA

08/03/2020

by: Tammy Binford

As employers continue to grapple with the COVID-19 pandemic, the U.S. Department of Labor (DOL) has released new guidance that attempts to answer questions related to employee pay and leave time.

Disability laws require aid for deaf patients: Ensure you’re prepared to comply

08/03/2020

by: Marla Durben Hirsch

Make sure your practice is prepared to treat patients who are deaf or hard of hearing. The government is ramping up its scrutiny of providers who fail to make the appropriate accommodations.

Communication aids for deaf patients: A review of what’s on the OCR-approved list

08/03/2020

by: Marla Durben Hirsch

Effective communication provides an equal opportunity to participate in, and enjoy the benefits of, a service, program or activity.

Despite PHE, provider signatures remain a must — except for ambulance orders

08/03/2020

by: Roy Edroso

Question: Like many practices, we’re doing a lot of telehealth during the public health emergency (PHE). Does this relieve or reduce our providers’ signature requirements for our Medicare claims?

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