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Proposed G codes offer payment for psychiatric, care management, mobility-related services

07/18/2016

You could find a slate of new reimbursement channels in 2017 when you provide certain behavioral health services to your patients as Medicare expands how it pays providers for the ongoing coordination of a patient’s care.

Surgeons will report visits during global period with G codes in 2017

07/18/2016

by: Laura Evans, CPC

Physicians who bill Medicare for the 4,200 surgical codes with 10- or 90-day global periods will have eight new unpaid G-codes to report next year for the visits and other services they provide during the global period, the agency announced in the proposed 2017 Medicare physician fee schedule.

Watch for new Medicare Advantage enrollment requirements, data sets

07/18/2016

by: Roy Edroso

CMS wants to require all providers and suppliers involved in Medicare Advantage services — including HMOs, Program of All-inclusive Care for the Elderly (PACE) and other organizations — to be enrolled in Medicare “in an approved status,” according to the proposed 2017 Medicare physician fee schedule.

CMS proposes Medicare program for pre-diabetic patients, non-licensed coaches

07/18/2016

by: Roy Edroso

CMS is rolling out a service for pre-diabetic patients that you might want to consider as a case partner – or even as a service to take on board at your own practice.

CMS targets prolonged services, epidural injections and more with RVU changes

07/18/2016

by: Part B News staff

Check out CMS’ proposals for relative value units (RVUs) of revised and new codes. CMS included these codes in the proposed 2017 Medicare physician fee schedule as part of its plan to seek public comment on proposed RVUs for new, revised and potentially misvalued codes.

New moderate sedation policy includes new billing rules, 7 new codes

07/18/2016

by: Julia Kyles, CPC-A

Providers who perform services that include moderate sedation will need to report the sedation to get paid in full. Providers who perform stand-alone moderate sedation services will not have to rely on carrier pricing next year, if CMS goes through with changes it announced in the Medicare proposed physician fee schedule.

Pay cuts for film X-rays, review of 0-day global period codes and more in proposed fee schedule

07/18/2016

by: Part B News staff

Part B News has scoured the 856-page proposed 2017 Medicare physician fee schedule and pulled out the notable plans for practices next year. To comment on the proposals, visit www.regulations.gov.

Compare current vs. proposed 2017 payment rates for commonly billed codes

07/18/2016

by: Laura Evans, CPC

The following table shows Medicare professional reimbursement for commonly billed codes at this year’s rates ($35.8043 conversion factor) compared with proposed 2017 proposed rates, including revisions to relative value units and the revised conversion factor of $35.7751. Payment rates are compared for both the facility and non-facility setting. All fees are par, not adjusted for locality.

Add Medicare Advantage patients to your CCM rolls – when they’re covered

07/11/2016

by: Richard Scott

Check the fine print on your payer contracts, because you may be able to bill your Medicare Advantage carriers when you provide chronic care management (CCM) services to patients covered under these non-traditional Medicare plans.

Write, revisit BAA policies that protect you when associates mess up HIPAA

07/11/2016

by: Roy Edroso

A recent Office for Civil Rights (OCR) settlement that fixes responsibility for a HIPAA breach on a business associate underlines the importance of making sure you have proper, current and well-managed business associate agreements (BAAs) for every relevant vendor.

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