Part B News | Editors' Blog

Breaking: CMS proposes 11% cut to 2021 conversion factor, confirms E/M coding overhaul

by: DecisionHealth Staff Aug 4, 2020

You can expect to see wild swings to Medicare pay rates in 2021, according to proposals CMS released this morning. The agency announced a nearly 11% cut to the Medicare physician fee schedule’s conversion factor (CF), dropping it to a rate of $32.26 next year, down from $36.09 in 2020.

Influencing the substantial decrease to the CF are the projected pay increases to the core set of E/M office visit codes (99202-99215). CMS confirmed that the E/M office visit codes remain on track for their first major overhaul in 25 years, according to the proposed 2021 Medicare physician fee schedule.

QPP updates: MVP Pathways postponed, threshold raised

by: Roy Edroso Aug 4, 2020

The Quality Payment Program is delaying a major overhaul planned for 2021: Its MVP (MIPS Value Pathways) upgrade, which was meant to move participants “away from siloed activities and measures and towards an aligned set of measures that are more relevant to a clinician’s scope of practice,” has been delayed due to “stakeholder concerns” and COVID-19. Instead, CMS will make “additions to the framework’s guiding principles and development criteria” for 2022.

Go to your room: Counseling patients to isolate after COVID-19 tests is a billable service [Update]

by: Julia Kyles, CPC Jul 30, 2020

CMS and the CDC agree: If your practice is testing for COVID-19, a physician or qualified health care professional should counsel the tested patients about what to do and what to expect while they wait for results, and they can be paid for the counseling.

Health care lawyer on the 1557 Final Rule, discrimination, and provider religious rights

by: Roy Edroso Jul 14, 2020

Part B News recently explored the ramifications of the recenlty-published final 1557 rule and the Bostock Supreme Court decision that seems to invalidate its effect on medical practice. Here with further thoughts on the subject is Melodie Hengerer, of counsel with Baker Donelson in Baltimore.

CMS sets 8/31 deadline for new ABN, instructions

by: Julia Kyles, CPC Jul 9, 2020

Get ready to update your Advance Beneficiary Notice of non-coverage (ABN) forms. Medicare has released a new form and instructions that will be mandatory on Aug. 31. The new forms have a 06/30/2023 expiration date in the footer and your practice may use them now.

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