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11/20/2023
On October 13, the OIG published an Advisory Opinion regarding a proposed arrangement where an employer proposed to pay a bonus to its employed physicians based on net profits derived from certain procedures performed by the physicians.
11/20/2023
On October 11, CMS published a Final Decision Memo regarding the reconsideration of NCD 20.7 for Percutaneous Transluminal Angioplasty (PTA) of the Carotid Artery Concurrent with Stenting.
11/20/2023
The conversion factor may be pulling down fees in 2024, but some codes are bucking the trend. In some instances, CMS decided to recast the relative value units (RVU) tied to non-facility payments, and fees are jumping.
11/13/2023
The conversion factor (CF) cuts that CMS floated earlier in the year are now confirmed — and heightened. Part B providers will have to prepare for a net 3.4% payment decrease across services in 2024.\
11/13/2023
You can now fully prepare for the launch of the long-anticipated and much-disputed add-on code G2211 (Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient’s single, serious condition or a complex condition).
11/13/2023
You can report the add-on code G2211 when providers take a long-term view of patients’ health status. But some situations may arise where you see a patient for a “single, serious condition” and the code still applies. Consider the following scenario from CMS:
11/13/2023
CMS finalized its plans for community health integration (CHI) and principal illness navigation (PIN) services, two new types of care management services represented by three code pairs that will go into effect Jan. 1, 2024.
11/13/2023
Your providers can receive additional revenue when they check a patient for social determinants of health (SDOH), but the service requires patient selection, a standardized tool and follow up when the provider determines the patient has an unmet SDOH that impacts their treatment.
11/13/2023
The Quality Payment Program (QPP) changes in the final 2024 Medicare physician fee schedule deliver a reprieve to the Merit-based Incentive Payment System (MIPS) performance threshold but bring cuts to other value-based programs, with worse possibly to come.
11/13/2023
The proposed changes to behavioral health coverage that CMS calls among the most important in Medicare history are all finalized — and expanded.

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