Part B News | Editors' Blog

Chapter 11 for physician practices: 'Not just for major players'

by: Roy Edroso Oct 1, 2024

Recent Gibbins Advisors analysis finds that “a relatively high percentage (30%) of very large health care bankruptcies (liabilities >$500M) were [private equity]-backed.” This suggests that the large scale of PE acquisitions, and their tendency to “roll up” smaller entities into larger ones, makes their managers likely to opt for bankruptcy as a tool when finances get difficult.

Prepare for 2025 success with coding, billing and compliance virtual events

by: Richard Scott Aug 20, 2024

Medical groups are bracing for a 3% cut to the Part B conversion factor in 2025, as CMS announced in the proposed 2025 Medicare physician fee schedule. The agency also made important announcements about telehealth services, previewed new codes eligible for billing in the new year, and added a slew of behavioral health services.

Don't miss out on the latest billing, coding, compliance and revenue cycle updates coming next year. DecisionHealth, the publisher of Part B News, is running a series of live virtual events intended to boost your proficiency and revenue cycle management and put you on track for a successful 2025 billing year.

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.

Sneak preview: 4 highlights from the proposed 2025 Medicare physician fee schedule

by: Julia Kyles, CPC Jul 9, 2024

The contents of Medicare’s proposed physician fee schedule are typically a mystery until CMS publishes the rule on the Federal Register. But this year is different.

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.

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