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.

New ICD-10-CM guidelines revise COVID-19 instructions, advise on social factors

by: Laura Evans, CPC and Julia Kyles, CPC Jul 8, 2020

Coders and medical practice staff can get a head start on a series of updated rules for diagnosis coding – the 2021 version of the ICD-10-CM Official Guidelines on Coding and Reporting was issued today – weeks ahead of the typical early August release date.

Proposed 2021 ICD-10-CM update flashes nearly 500 new codes, additional changes

by: Laura Evans, CPC & Julia Kyles CPC May 11, 2020

Coders will have hundreds of new ICD-10-CM codes to report Oct. 1, including codes for sickle cell anemia and osteoporosis. In addition, they’ll find a series of new options for headache codes.

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.

CMS cements fresh round of COVID waivers, upping payments, expanding telehealth

by: DecisionHealth Staff Apr 30, 2020

A second wave of policy and payment changes that CMS released today is reshaping – yet again – how the medical community can conduct care during the COVID-19 crisis and, critically, how much providers can expect to get paid.

In a wide-ranging update to policy guidance that CMS is touting as a “second round of sweeping changes,” the agency seeks to further expand COVID care, ramp up diagnostic testing and again loosen restrictions on which types of providers can deliver vital services like telehealth during this unprecedented emergency.

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