Part B News | Benchmark of the Week

Medicare FFS enrollment sputters as Medicare Advantage moves in

09/27/2021

The latest Medicare enrollment numbers show that while Medicare Advantage continues to gain a share of covered patients, traditional Medicare is fading fast.

Use 2020 telehealth report as a baseline for internal review

09/20/2021

by: Julia Kyles, CPC

The number of office E/M visits performed via telehealth spiked in April 2020, a sign that medical practices around the country took advantage of the relaxed rules for telehealth services that went into effect March 1, 2020.

Health spending remains down 7% through first half of 2021

09/13/2021

by: Richard Scott

The financial fallout of the COVID-19 pandemic continued well into 2021, and a return to normal spending levels doesn’t have a clear timeline, according to new research.

Per-patient E/M payments fluctuate by state; use them for audits

08/30/2021

by: Julia Kyles, CPC

Use Medicare’s average per-patient payment for all E/M visits in your state as the starting point for your internal review of E/M claims to see how your payments compare to those of your peers in the same area.

ESRD code tops list of fee winners; cardio codes lose big

08/23/2021

by: Richard Scott

You can expect big pay gains for chronic care management (CCM) codes in 2022, but that’s not the only service in line for a reimbursement surge. By strict dollar gains, the biggest winner for services in the non-facility setting is monthly end-stage renal disease service code 90954, with fees up $206 year to year.

Proposed cuts to E/M office visits prove less harsh than other settings

08/16/2021

by: Roy Edroso

No matter the setting, you can expect a reduction in payment for a large swath of E/M codes in 2022, according to a Part B News analysis of payment adjustments mandated within the proposed 2022 Medicare physician fee schedule.

Proposed cuts hit 38 of 40 high-utilization procedures, visits in CY2022

08/02/2021

by: Roy Edroso

Last year saw plenty of double-digit cuts in the “selected procedures” that CMS traditionally calls out to show the impact of the proposed physician fee schedule (PFS) on a suite of Medicare’s most frequently used codes.

2022 fee tally: Winners and losers under the proposed physician fee schedule

07/26/2021

by: Richard Scott

As providers brace for a nearly 4% cut to the 2022 conversion factor, the impact of relative value unit (RVU) changes on specialties fluctuates from a 10% gain for portable X-ray suppliers to a -9% drop for interventional radiology.

Numbers show public concern with surprise billing made new regs inevitable

07/19/2021

by: Roy Edroso

The new and upcoming rules related to surprise billing promise big changes for the health care industry, but as you can see from a series of figures from the Kaiser Family Foundation first published on Feb. 11, 2020, the issue had penetrated the consciousness of a large number of Americans and become a political issue that could hardly be ignored.

Medicare Advantage takes another bite out of traditional FFS enrollment

07/12/2021

by: Richard Scott

Medicare Advantage enrollment galloped forward at a 10% rate between 2020 and 2021, as the private plan alternative to original Medicare now has lassoed more than four in 10 (42%) beneficiaries.

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