Home | News & Analysis
Benchmark of the Week
Take a look at proposed physician payments for new services: CMS included fees for 43 new CPT codes and seven HCPCS G codes in the proposed 2024 Medicare physician fee schedule.
When subbing in a physician under locum tenens arrangements, the situation often involves diagnostic radiology services and cancer care. Among E/M services, hospital visits are more likely to involve a substitute physician than office visits.
Check your claims for subsequent annual wellness visits (AWV) (G0439) against state level data. You can mine the information to provide a more nuanced picture of your billing data, capture a peek into the services your competitors provide and alert you to coding patterns that warrant a closer look.
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).
Among the services for which CMS proposes to raise reimbursement by the largest percentage in CY 2024, there’s a thread of E/M codes that meet two of CMS’ recent areas of focus – remote services and bundled care.
A glimpse ahead to 2024 payment rates reveals an up-and-down outlook for physician specialties and their allowable charges. Setting the bar at a 2% gain or loss, 10 specialties find themselves on the positive side of the ledger in combined relative value unit (RVU) impact, while 18 specialties are projected for cuts.
The years-long decline in claims with modifier 78 (Unplanned return to the operating room by the same physician following initial procedure for a related procedure during the postoperative period) was accelerated by the pandemic in 2020. This downward trend appears to have continued in 2021: The total number of claims made with 78 dropped precipitously, from 87,826 in 2020 to 65,857 in 2021, a decline of 25%.
Auditors are keying in on psychotherapy services delivered via telehealth, and Medicare claims show that they will have a massive trove of data to investigate. In 2021, as the COVID crisis continued to shutter offices, providers routinely turned to telehealth to deliver behavioral health care to patients after CMS granted waivers, capturing some 40% of visits on the most-used services.
More than 60% of physicians are “very” or “somewhat” satisfied with their electronic health record (EHR) systems and described documenting clinical care – whether they use a paper or EHR system – as “very” or “somewhat” easy, according to analysis of the last three National EHR Surveys, which contain data for 2018, 2019 and 2021.
The latest Quality Payment Program (QPP) Experience Report, released on June 12, showed the number of eligible providers in MIPS declined, though Advanced APM participants rose. And as usual nearly everyone escaped a penalty, though bonuses remain low.


User Name:
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Back to top