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More on G2211: Consider a scenario for a single 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:

Investigate the new community health, PIN care management services

11/13/2023

by: Julia Kyles, CPC

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.

Social determinants of health assessment requires approved tool, follow up

11/13/2023

by: Julia Kyles, CPC

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.

MIPS bonus threshold sticks at 75, as lower APM bonuses signal hurdles to come

11/13/2023

by: Roy Edroso

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.

Behavioral health expansion opens the way to new billing providers

11/13/2023

by: Roy Edroso

The proposed changes to behavioral health coverage that CMS calls among the most important in Medicare history are all finalized — and expanded.

CMS delays Shared Savings CEHRT and quality measure switch, but not for long

11/13/2023

by: Roy Edroso

CMS has given participants in its premier ACO initiative, the Medicare Shared Services Program (MSSP), a year before they have to transition to a new standard for compliance with certified EHR technology (CEHRT) and mandatory digital clinical quality measures (CQM) reporting. But it appears many stakeholders are hoping for further reprieve.

PFS round-up: Telehealth sticks, split or shared aligns, misvalued codes targeted and more

11/13/2023

by: Part B News Staff

Discover additional policy changes contained in the final 2024 Medicare physician fee schedule, from misvalued services to split or shared billing policy and more. Get all the latest here:

2024 specialty impact: Endocrinology, family practice up, dozens down

11/13/2023

by: Richard Scott

The final specialty-based fee projections look a lot like the ones CMS proposed several months ago. Setting the threshold at positive or negative 2%, a total of 10 specialties are on pace to see fee gains in 2024, while 18 are in the red.

Young physicians seek money. Don’t have much? Try equity, loan plans.

11/06/2023

by: Roy Edroso

New findings show that young physicians, laboring under huge medical school debt, are attracted to the jobs that promise the most generous compensation. If you want those providers and you can’t compete on price, however, there are other ways to get their attention.

Coding veterans offer praise, express concern, about new split or shared guidelines

11/06/2023

by: Julia Kyles, CPC

Coding and compliance veterans saw a nod to best documentation practices, a possible return to attesta- tions and potential billing confusion after their initial read of the 2024 CPT manual’s revised split or shared guidelines, released in early October.

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