Part B News | Editors' Blog

Breaking: Fee cuts confirmed, behavioral health big focus in final 2025 PFS

by: DecisionHealth Staff Nov 1, 2024

The Part B fee cuts are coming. After CMS proposed an across-the-board 2.8% reduction to the Medicare Part B conversion factor in July, the agency today confirmed that the rate-setting reduction is on track to kick in on Jan. 1, 2025.

Within the 3,088 page final 2025 Medicare physician fee schedule that was released this afternoon, CMS also finalized a diverse range of new service, such as caregiver training and a host of mental health-adjacent codes, largely punted on telehealth reform, confirmed the requirement of surgical transfer of care modifiers, and tweaked its quality-reporting programs.

Discover guideline revisions, 400+ code changes in 2025 CPT update

by: Julia Kyles, CPC, Laura Evans, CPC, and Richard Scott Oct 9, 2024

Get ready to dig into more than 400 code changes as part of the 2025 CPT code set. That includes 270 new codes, including dozens of surgical codes, as well as 112 deletions and 38 revisions.

You’ll also find numerous guideline changes within the 2025 CPT Manual, with expanded guidance for the new CPT-based virtual check-in service and online digital E/M services. The AMA released the revised CPT code set in September, while the full guidelines are now accessible as the books are available for purchase ahead of the Jan. 1 implementation date.

Breaking: Part B fees under fire, as CMS redesigns policy, coverage rules in proposed 2025 PFS

by: DecisionHealth Staff Jul 10, 2024

You can say goodbye to the elevated payment rates that have buoyed Part B professional fees for most of 2024. Should CMS' proposals in the latest physician fee schedule hold, providers and medical groups will see a nearly 3% reduction to the Medicare Part B conversion factor in 2025.

The agency also announced plans to launch a slate of advanced care management services, set a deadline for big changes in the Merit-based Incentive Payment System, teased 2025-effective codes, floated a revamp of surgical modifier rules, and signaled the end of many entrenched telehealth flexibilities, among other policy changes and revisions, according to the proposed 2025 Medicare physician fee schedule, and its 2,248 pages of Medicare policy, released today.

Encounter for sepsis aftercare code finalized as part of FY2025 ICD-10-CM code update

by: Megan Herr Jul 3, 2024

Effective Oct. 1, coders will now have a way to capture a post-acute encounter for sepsis aftercare with the new code Z51.A (Encounter for sepsis aftercare).

This code, which was one of the 252 codes proposed earlier this year, was finalized as part of the FY2025 ICD-10 final code update — released July 3 by CMS along with the guidelines.

Breaking: More than 250 new ICD-10 codes proposed for Oct. 1

by: Megan Herr and Julia Kyles, CPC Apr 10, 2024

The proposed ICD-10 code changes — released with the FY2025 Hospital Inpatient PPS (IPPS) proposed rule on April 10 – include three new codes to better track the severity of patients with hypoglycemia.

The proposed rule includes 252 new codes, 13 revised code descriptors and 36 codes deemed invalid. If finalized, these changes would take effect Oct. 1.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.

Your new password should have at least 6 characters.
Current Password
New Password
Confirm Password