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While the Shared Savings program, CMS’ premier accountable care organization (ACO) network, has been saving the government money, it’s also leaking participants — down from 561 in 2018 to 477 in 2021. While the program appears safe for the immediate future, there’s no guarantee it won’t eventually give way to other models, which means providers should keep an eye on the latest value-based trends.
Lawmakers are trying to delay the first reporting deadline for the COVID-based Provider Relief Fund (PRF), currently scheduled for the end of September. Experts say you shouldn’t count on it happening. But do count on HHS auditing your payments, and document and report accordingly.
Question: The specialists at our practice regularly perform what we call virtual consults and we’re wondering if there’s any payment for their work. Typically, a primary care physician will call or send an email asking for advice on treating one of their patients. It usually takes our doctors a few minutes to review the data the requesting doctor provides and email a reply. But some cases are complicated and include review of several test results, some research and long conversations with the requesting doctor. The patient does not come to our office and, in most cases, our physicians have never seen the patient. We know we can’t bill an office visit (99202-99215), a consult (99241-99245 or 99251-99255) or a virtual visit (G2010 or G2012). Are there any other options?
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.


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