Home | News & Analysis | PBN Benchmarks
Benchmark of the Week

If providers at your practice implant neurostimulator electrode arrays, you could be in for a financial windfall in 2018. But if you perform a lot of allergy scratch tests, you’ll likely take a hit.


You’ll find a small payment increase in 2018 for several frequently reported E/M codes, including a 1% jump for office code 99214, which brings the non-facility payment rate to $109.44 per encounter — up a smidge from the 2017 rate of $108.74.

Surgeons are most likely to work in tandem with a non-physician practitioner (NPP) when performing a procedure under Medicare Part B, says a review of surgical modifier claims data.

It looks like things were a little bit better for providers in 2016 than in 2015 as they got more reimbursement with fewer denials.

Do a quick calculation on your drug-code billing; some groups that bill a lot of Part B-covered drugs may see wild swings in their Medicare payment rates under the merit-based incentive payment system (MIPS) in future years.

Of the 82 CPT codes that are to be cleared out as part of the latest CPT changes, two popular codes slated for deletion may especially have an effect on your revenue if you’re not paying attention.


Get ready to pivot to a new suite of imaging codes in 2018 to avoid revenue disruptions that may occur as a slate of current X-ray codes go on the chopping block.

Take note of some interesting patterns among specialties when it comes to hospital inpatient codes, even if the codes’ utilization and denial rates haven’t changed much in recent years.

Many specialty groups beyond primary care took in significant chronic care management (CCM) payments in 2015, with the $31.3 million in reimbursement spread across dozens of specialties.


Of the six eye exam codes eye that will be bundled in new CCI code pairs, four had relatively stable denial rates between 2011 and 2015 — but two of them had remarkably high and much less stable denial rates.


User Name:
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Back to top