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.

Use 8 more tips for telehealth coding during the public health emergency

by: Julia Kyles, CPC Jun 2, 2020

Medicare issued an update to its COVID-19 fact sheet May 27, and it contains more answers your telehealth documentation and coding questions.The topics relevant to Part B billing range from modifier use to how to report a telehealth encounter if the practitioner or the patient experience technical difficulties.

Don’t get your wires crossed during telephone E/M encounters

by: Julia Kyles, CPC May 15, 2020

The big pay boost for telephone E/M codes performed by physicians and qualified health care professionals (99441-99443) is good news for practices that have performed audio-only telephone encounters during the COVID-19 emergency.

In addition, the update should remind practices to make sure they know when they can report an office E/M telehealth visit and determine if their state’s Medicaid program will reimburse the practice for audio-only encounters.

Providers can now perform 89 telehealth services with a telephone call, CMS says

by: Julia Kyles, CPC May 1, 2020

A phone call with a patient — plus complete documentation — will be all it takes to report 89 services on Medicare's telehealth list. Practices will also be able to receive full reimbursement for 39 new services performed via telehealth, according to the updated telehealth list posted today. The changes are retroactive to March 1.

MedPage Today: Telehealth expansion opens the door to reimbursement troubles

by: Julia Kyles, CPC Apr 17, 2020

CMS and private payers have knocked down barriers for telehealth and telemedicine services during the COVID-19 public health emergency (PHE). But a MedPage Today article reveals that barriers to payment remain, and the steady flow of changes to coding and billing guidance is a major hurdle.

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