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Benchmark of the Week
The latest Medicare enrollment numbers show that while Medicare Advantage continues to gain a share of covered patients, traditional Medicare is fading fast.
The number of office E/M visits performed via telehealth spiked in April 2020, a sign that medical practices around the country took advantage of the relaxed rules for telehealth services that went into effect March 1, 2020.
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.
Use Medicare’s average per-patient payment for all E/M visits in your state as the starting point for your internal review of E/M claims to see how your payments compare to those of your peers in the same area.
You can expect big pay gains for chronic care management (CCM) codes in 2022, but that’s not the only service in line for a reimbursement surge. By strict dollar gains, the biggest winner for services in the non-facility setting is monthly end-stage renal disease service code 90954, with fees up $206 year to year.
No matter the setting, you can expect a reduction in payment for a large swath of E/M codes in 2022, according to a Part B News analysis of payment adjustments mandated within the proposed 2022 Medicare physician fee schedule.
Last year saw plenty of double-digit cuts in the “selected procedures” that CMS traditionally calls out to show the impact of the proposed physician fee schedule (PFS) on a suite of Medicare’s most frequently used codes.
As providers brace for a nearly 4% cut to the 2022 conversion factor, the impact of relative value unit (RVU) changes on specialties fluctuates from a 10% gain for portable X-ray suppliers to a -9% drop for interventional radiology.
The new and upcoming rules related to surprise billing promise big changes for the health care industry, but as you can see from a series of figures from the Kaiser Family Foundation first published on Feb. 11, 2020, the issue had penetrated the consciousness of a large number of Americans and become a political issue that could hardly be ignored.
Medicare Advantage enrollment galloped forward at a 10% rate between 2020 and 2021, as the private plan alternative to original Medicare now has lassoed more than four in 10 (42%) beneficiaries.


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