Part B News | Part B News

Fee schedule round-up: Dental services, MDPP, vaccine fee rates and more

11/18/2024

Discover additional coverage and policy changes contained in the final fee schedule, from an expansion of dental services and vaccine payment rates to diabetes program changes and overpayment rules. The round-up below digs into the deeper, but no less important, portions of the final rule.

Conversion factor impact will vary for high utilization codes

11/18/2024

by: Julia Kyles, CPC and Laura Evans, CPC

You’ve read about the coming 2.8% pay cut that is on deck for 2025. However, a closer look at specific codes reveals that the impact of the cut will vary across services that are covered under the final 2025 Medicare physician fee schedule.

CMS confirms fee cuts, expands behavioral health services in final 2025 PFS

11/11/2024

by: DecisionHealth staff

Brace for impact: Part B fee cuts are coming. After CMS proposed an across-the-board 2.8% reduction to the Medicare Part B conversion factor in July, the agency confirmed that the rate-setting reduction is on track to kick in on Jan. 1, 2025.

As docs cite pay crunch, consider incentive packages as a hiring tool

11/11/2024

by: Roy Edroso

Recent survey results on physician compensation underscore a trend seen in other payment-related surveys: While physicians complain of lower reimbursement rates, median total cash compensation (TCC) generally seems to be up. Experts suggest that physicians in larger organizations are insulated from the payment shortfalls suffered by their smaller-practice colleagues, who must try to make up the gaps with creative recruitment strategies.

Social workers, psychology see RVU gains in 2025; a dozen are down

11/11/2024

by: Richard Scott

Take note of relative value unit (RVU) changes for specialty-specific services within the final 2025 Medicare physician fee schedule. The projected gains in allowable charges for select specialty groups in 2025 are led by clinical social workers (+4%), clinical psychologists (+3%) and anesthesiology providers (+2%), who will see the biggest RVU gains on net.

As AI proliferates, keep its use ‘on-label,’ protect your data

11/04/2024

by: Roy Edroso

The use of generative artificial intelligence (AI) in health care continues its rapid expansion. But a recent investigation of one product’s possible flaws serves as a reminder that the technology remains immature and in many cases guardrails are required, especially when it impacts patient care.

Implement tips on split/shared billing from 3 top specialties

11/04/2024

by: Julia Kyles, CPC

Take note of tips for using modifier FS (Split or shared services) from top reporters as the modifier approaches its third year of active status. CMS implemented the modifier as part of a major revision to its rules for split/shared services, on Jan. 1, 2022. The modifier dictates payment, so accuracy is crucial to prevent overpayments, underpayments and compliance problems.

Overpayments rule would grant 180-day investigations. Is it enough?

11/04/2024

by: Roy Edroso

A little-noticed feature of the proposed 2025 Medicare physician fee schedule (PFS) having to do with the reporting and return of overpayments could be finalized soon, and it might change the timetable for refunds that you owe.

HIPAA Q&A: Navigate data sharing, recent HIPAA rules changes

11/04/2024

by: Rebecca Herold, CDPSE, FIP, CISSP, CIPM, CIPP/US, CIPT, CISM, CISA, FLMI

Question: How should compliance leaders navigate the complexities of data sharing and interoperability initiatives while maintaining strict adherence to HIPAA regulations?

CMS revises Medicare Preventive Services tool

11/04/2024

by: DecisionHealth staff

On October 14, CMS updated its Medicare Preventive Services website with new information on a variety of topics.

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