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05/19/2025
New findings from the American Association of Physician Associates (AAPA) show that PAs remain a growth industry — not only in number and compensation, but also in independent practice.
05/19/2025
Make sure your staff know when they can count the independent review of a test toward medical decision-making (MDM). Independent interpretation of a test can lift the level of the “amount and/or complexity of data to be reviewed and analyzed (data)” element of an E/M visit to moderate or extensive, depending on the work performed for an encounter.
05/19/2025
On May 12 the Trump administration announced a revival of the “Most Favored Nation” (MFN) drug pricing executive order (EO) similar to one it unsuccessfully tried to implement in President Trump’s first term. Apart from including Part D drugs and some more aggressive language than last time, administration officials did not immediately say how this attempt would achieve a different result.
05/19/2025
A recent enforcement action by the HHS Office for Civil Rights (OCR) highlights the consequences of failing to conduct an adequate risk analysis under the HIPAA Security Rule.
05/19/2025
Physician associate (PA) billing boomed in a recent five-year stretch, as total claims climbed dramatically and the frequently reported E/M office visits (99211-99215) surged to new highs.
05/12/2025
Even though Congress didn’t fully unleash telehealth services, instead extending the long-running telehealth waivers through September, making your telehealth services a permanent offering can improve your practice’s financial health.
05/12/2025
The recent closure of a major practice in Rhode Island, and the efforts of a separate practice to pick up their patients, raises the question: Is it out of line to actively solicit another provider’s patients?
05/12/2025
Physician-owned hospitals must conform to strict rules under Medicare, but a recent advisory opinion (AO) from CMS suggests a way they can expand their offerings without losing their status.
05/12/2025
Since 1976, the Office of Inspector General (OIG) has served as a compliance watchdog, overlooking all HHS programs and monitoring for instances of fraud, waste and abuse. While health care organizations can wait to investigate potential compliance issues until they receive an audit request or gain access to audit findings, you’re better off taking a proactive approach. One important step is monitoring for additions to the OIG Work Plan.
05/12/2025
Medicare utilization of many CPT codes, such as outpatient E/M codes, took a beating in the pandemic years. But use of the critical care code 99291 (Critical care, evaluation and management of the critically ill or critically injured patient; first 30-74 minutes) and add-on code 99292 ( … ; each additional 30 minutes) jumped higher during that period.

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