Part B News Features
Question: We are trying to understand the time requirements for G0316, G0317 and G0318. We thought CMS added an extra 15 minutes to the threshold times listed in the new CPT guidelines.... More
Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More
When Part B News looked at the “Impact on CY 2022 payment for selected procedures” that came with the physician fee schedule last year, there was not a single rate gainer among the 23 code... More
Question: We are trying to understand the time requirements for G0316, G0317 and G0318. We thought CMS added an extra 15 minutes to the threshold times listed in the new CPT guidelines.... More
Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More
When Part B News looked at the “Impact on CY 2022 payment for selected procedures” that came with the physician fee schedule last year, there was not a single rate gainer among the 23 code... More
Tools
Take a look at the new, revised and potentially misvalued services that CMS identified in the proposed 2023 Medicare physician fee schedule. The downloadable document (xls) provides current and projected work relative value units (RVU) for each service, allowing you to compare RVU changes between 2022 and 2023.
Observation-only E/M codes are slated for deletion as of Jan. 1, 2023. Part of the second phase of the E/M coding update folds observation codes into existing inpatient E/M codes and revises the inpatient codes’ descriptors. Use this crosswalk to train staff on the pending changes.
Benchmark of the Week
When Part B News looked at the “Impact on CY 2022 payment for selected procedures” that came with the physician fee schedule last year, there was not a single rate gainer among the 23 codes with non-facility rates. Flash forward to that list for 2023, and you’ll find that – with one significant exception – the situation is even worse.
Practices will experience a spike in denials for prolonged services in 2023 if they aren’t prepared for the next round of coding updates. Medicare Part B claims data show that denials for prolonged services by physicians and qualified health care professionals (QHP) in the outpatient setting (99354 and 99355) increased from an average of 10% in 2020 to an average of 30% in 2021.

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