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DEA prescribers should start MATE prep before their next renewal date

08/21/2023

Make sure clinicians who prescribe controlled substances complete the eight hours of training required by the Medication Access and Training Expansion (MATE) Act. Effective June 27, all prescribing clinicians who are registered with the Drug Enforcement Administration (DEA) must attest that they completed the training when they renew their registration or apply for the first time.

Make sure SUD training meets MATE’s requirements

08/21/2023

by: Julia Kyles, CPC

Whether your prescribers think they’ve met the MATE Act’s training requirements or they’re looking for a way to meet the training requirement before they renew their DEA license, make sure the substance use disorder (SUD) training is offered by a properly accredited group.

CMS makes a push to activate, pay for ‘caregiver training services’

08/21/2023

by: Richard Scott

You may find fresh billing opportunities when your providers enlist the help of caregivers in a patient’s treatment plan, according to the proposed 2024 Medicare physician fee schedule released July 13. CMS seeks to make active a suite of behavioral management and functional improvement training codes in 2024.

Accurately report JW, JZ modifiers before Oct. 1 enforcement

08/21/2023

by: Laura Evans, CPC

By now, most practices should be aware of the JW and JZ modifiers, which you are to append to codes for single-dose drug containers that you bill to Medicare Part B.

Map out state-level data for AWVs to see where your practice stands

08/21/2023

by: Julia Kyles, CPC

Check your claims for subsequent annual wellness visits (AWV) (G0439) against state level data. You can mine the information to provide a more nuanced picture of your billing data, capture a peek into the services your competitors provide and alert you to coding patterns that warrant a closer look.

Make sure the MVP fits your clinicians, run traditional MIPS as a backup

08/14/2023

by: Julia Kyles, CPC

Participation in the Merit-Based Incentive Payment System Value Pathway (MVP) program gives providers another opportunity to meet their quality payment participation goals this year.

On MA prior auth, Congress proposes relief — but CMS is ahead of the game

08/14/2023

by: Roy Edroso

A couple of new bills — or rather, retreads of old bills — demonstrate increased congressional interest in reforming prior authorization (PA) under Medicare Advantage (MA). While the success of these bills is not assured, a recent proposed rule shows CMS is willing to move on this issue itself, with Congress serving more as a cheerleader than as a legal authority.

CMMI dementia model aims to aid unpaid caregivers, patients

08/14/2023

by: Roy Edroso

CMS is launching a demonstration model that is not only aimed at dementia patients, a growing segment of U.S. health care consumers, but also designed to help these patients’ unpaid at-home caregivers via care coordination and "respite services."

More coverage of the proposed PFS: Vaccine pricing, policy updates and more

08/14/2023

by: Roy Edroso

Don’t miss out on yet more policy changes contained in the proposed 2024 Medicare physician fee schedule, from vaccine payments to the never-used Appropriate Use criteria and more. Get all the latest here:

E/M fee preview: Care management service tops list with 26% pay jump

08/14/2023

by: Richard Scott and Laura Evans, CPC

A number of services in the E/M category are on track for big pay gains in CY 2024, led by behavioral health care management (99484), set for a 26% jump to $54 per service, and joined by two prolonged services codes (99415, 99416).

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