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Part B News
In Part One of the 2020 strategic planning feature, published Jan. 13, we discussed how to identify leading indicators to optimize your business plan and operational success. In Part Two, below, you’ll find out how to anticipate threats and read success tips from a start-up solo practitioner.
Steer clear of common obstacles that can derail your use of modifier 25 (Significant, separately identifiable E/M service) and leave you with yawning gaps in revenue.
You should be monitoring the performance of alternative payment models (APM) that CMS and its Innovation Center have launched in recent years under non-traditional payment structures.
Medicare claims data for non-emergent hyperbaric oxygen (HBO) therapy and the introduction of a prior authorization model to support the procedure disclosed numbers that show the CMS program is working as intended — to curtail overuse. 
Both CMS and OIG say the drive to connect every Medicare beneficiary with their new Medicare beneficiary identifier (MBI), which has been required for claims since Jan. 1, has been successful.


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