Part B News | Benchmark of the Week

Pandemic sharpened decrease in psychiatric evaluation rates

05/23/2022

Despite their addition to the audio-only services list during the COVID-19 public health emergency (PHE), a series of psychiatric evaluation codes took a significant dip in 2020 when the pandemic suppressed claims across the board.

Doc to doc: Use of interprofessional consults surged in 2020

05/16/2022

by: Julia Kyles, CPC

The 2020 proliferation in communications-based services extended beyond patient encounters, as physicians increasingly consulted with one another via phone, internet or other electronic channels.

Hospital code use took double-digit hit in 2020, but denials stayed light

05/09/2022

by: Roy Edroso

Like many other services, hospital inpatient and observation numbers took a hit in the first pandemic year of 2020. But providers performed better in getting their claims accepted than before.

Behavioral health services continue to climb, revenue jumps

05/02/2022

by: Richard Scott

The growth of two services that Medicare has approved in recent years — cognitive assessment service 99483 and behavioral health care management code 99484 — signals that practices are spending more time addressing their patients’ behavioral health needs.

In 2020, COVID fueled a year of ups and downs for ABNs

04/25/2022

by: Julia Kyles, CPC

Providers issued fewer advance beneficiary notices of non-coverage (ABN) during the first year of the COVID-19 public health emergency (PHE) than they had in previous years, even as two ABN modifiers grew in popularity.

Practices keep X modifiers over 6M threshold, beating 59’s denial rates

04/18/2022

by: Roy Edroso

While use of modifier 59 (Distinct procedural service) dropped during the first COVID year of 2020, practices reported the four X modifiers that can be used in place of 59 at a similar clip as in 2019, and denials stayed comparatively lower.

Shared Savings reverses slide, gaining members – and patients

04/11/2022

by: DecisionHealth Staff

More groups opted into the Medicare Shared Savings Program (MSSP) in 2022 than they did the previous year, ending a one-year slide that had softened enrollment rates in the national value-based model.

Audio-only clearance didn’t boost behavioral health codes

04/04/2022

by: Roy Edroso

Behavioral health codes cleared for phone use in 2020 did not gain much in utilization compared to previous years, but providers were largely successful when reporting them.

Audio-only option tied to big jumps in E/M utilization

03/28/2022

by: Julia Kyles, CPC

The audio-only option that CMS cleared for certain E/M services during the COVID-19 public health emergency (PHE) was a boon for medical practices, according to a Part B News analysis of Medicare claims data. While utilization of E/M services that did not have an audio-only option fell 14% between 2019 and 2020, services that were audio-eligible faced just a 3% dip – a considerable win in an overall depressed claims era.

Care delays, staff burden: PA process still rankles, worries

03/21/2022

by: Richard Scott

The long-standing challenge of the prior authorization (PA) process, which providers have cited as an impediment to care for years, has not become easier to navigate and still puts patients at harm, industry surveys indicate.

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