Part B News | Benchmark of the Week

Some specialties should make plans to avoid to-be-deleted 99201

09/21/2020

You’ll have one fewer E/M office visit code to report in 2021 after the AMA finalized its plan to delete 99201 from the CPT master list. While use of 99201 is trending down, some specialties that have continued to stick with it should hardwire alternative options into their 2021 coding scheme.

New patient E/M codes a hard lift for many specialties, psychiatry especially

09/14/2020

by: Roy Edroso

With the Level 1 new patient office E/M code 99201 going away next year, it’s worth considering how your specialty performs with the other new patient office visit codes.

Big gains for phone E/M codes, immunizations part of select few with 2021 increases

08/31/2020

by: Richard Scott

You can welcome a handful of triple-digit gainers among codes taking a fee increase in 2021. But such pay gains project to be something of an anomaly next year, according to code valuations CMS released alongside the proposed 2021 Medicare physician fee schedule.

2021 list of fees for ‘selected procedures’ shows deep, steady cuts

08/24/2020

by: Richard Scott

You won’t find many plus signs on the list of “selected procedures” that CMS released alongside the proposed 2021 Medicare physician fee schedule. Except for E/M services, reduced fees dominate.

In E/M watershed year, most specialties projected to take a reimbursement bath

08/17/2020

by: Roy Edroso

The extraordinary redistribution of allowable fees within the physician fee schedule is on pace to produce some crooked numbers in 2021. The payment outlook appears grim for a number of specialties whose reimbursement on top codes CMS proposes to reduce dramatically. Yet some specialties will still see gains.

Lesion removal, blood draws top list of non-E/M codes in the office

08/10/2020

by: Richard Scott

Of the millions of procedures performed in place of service (POS) 11 (Office) every year, lesion-destruction services are some of the most frequently reported. Debriding nails and joint injections are other common non-E/M services.

Telehealth visits start declining as in-person encounters bounce back: Study

08/03/2020

by: Roy Edroso

Telehealth has emerged as a big part of American health care in the COVID-19 era, and in its early days some practices reported most of their visits being done by videoconference or phone. But a recent study from The Commonwealth Fund suggests that telehealth use may be trending down as practices reopen.

Robust TCM payment growth slows but still sees double-digit results

07/27/2020

by: Richard Scott

The ascendance of transitional care management (TCM) payments and claims may be slowing, but the codes (99495-99496) continue to maintain strong year-to-year growth, most recently reaping more than $186 million in Part B payments.

APMs, QPs and groups gain, virtual groups vanish in Quality Payment Program Report

07/20/2020

by: Roy Edroso

CMS’ 2018 Quality Payment Program (QPP) Experience Report that came out on July 7 suggests that Alternative Payment Models (APMs) are slowly gaining on traditional individual and group reporters — and virtual groups are washing out.

Multiple procedures on same DOS clear payment systems with few denials

07/13/2020

by: Richard Scott

Getting paid for more than one procedure on the same date of service was not much of a challenge for providers in recent years, judging by the claims data on modifier 51 (Multiple procedures).

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.