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12/19/2011

Amid all of the worry about looming Medicare cuts, here’s a kernel of good news: President Obama has repealed the 3% pre-payment tax withholding that would have applied to your Medicare payments. The repeal law, titled “3% Withholding Repeal and Job Creation Act” and signed Nov. 21, kills a little known change in the tax law that would have withheld 3% of your Medicare reimbursements and applied it to your federal taxes owed for that year.

12/19/2011

You will be getting an extra year to prepare for the next level of meaningful use requirements, HHS officials say. Right now, you only have to meet stage 1 meaningful use rules, but in 2013 you would have to meet tougher stage 2 requirements. Stage 2 is being delayed to 2014, giving you an extra year to enjoy federal electronic health record (EHR) incentives while meeting only stage 1 requirements.

12/19/2011

These charts look at Medicare denial rates for eight minor in-office procedures in 2009 and 2010, comparing denials for primary care practices and specialists. NOTE: “Primary care” is a combination of data from general practice, family practice, internal medicine and OB/GYN. NOTE: “Specialists” combines data from most other Medicare-recognized specialties, excluding those with low annual utilization such as plastic surgery.

12/19/2011

Your non-physician practitioners (NPPs) will play leading roles in providing three newly covered services in 2012: screening and counseling for obesity, alcohol misuse and depression. These conditions are currently addressed as part of an office visit and you don’t get any separate reimbursement for them, experts say.

12/19/2011

You can optimize your practice’s time by knowing when to it’s ok bill non-physician practitioner (NPP) services under your physician’s national provider number (NPI) outside of billing incident-to. While your NPPs can’t bill under the doctor’s NPI for major services such as E/M visits without meeting all of the incident-to requirements or billing under their own number, there are threekey scenarios in which you can that will optimize physician and staff time, experts say.

12/19/2011

These charts show 10 codes billed by non-physician practitioners (NPPs) that have relatively low denial rates, but were responsible for a major chunk of lost reimbursement in 2010. The top chart shows the average dollar amount lost per single denial in 2009 and 2010, while the bottom chart shows the average denial rate. NOTE: For the purpose of this analysis, NPPs include certified nurse midwives, certified registered nurse anesthetists (CRNAs), chiropractors, clinical nurse specialists, nurse practitioners, physician assistants and physical therapists. CMS does not distinguish between physician-billed services and those billed incident-to by NPPs, so this data excludes incident-to services.

12/19/2011
12/16/2011

CMS is now going to cover one face-to-face visit each year for cardiovascular disease prevention. How should the new face-to-face visit be coded assuming that it’s separate from the annual wellness visit (AWV) and the health risk assessments (HRA)? Also, when does this take effect?

12/12/2011

You face a 27.4% Medicare pay cut in three weeks, possible payment freezes from the HIPAA 5010 switch and the certainty of patients on high-deductible plans who are basically self-pay from a collections standpoint. Your best protection is a beefy line of credit, experts say.

12/12/2011

You will see slight pay bumps for primary care services and some cuts to imaging specialty payments next year under the final 2012 final Medicare Physician Fee Schedule (PFS) thanks to CMS entering its third year of a four-year transition to a new dataset to calculate relative value units (RVUs) and not the five-year review, a Part B News analysis shows.

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