Part B News Features
Question: Can we report G0136 (Administration of a standardized, evidence-based Social Determinants of Health [SDOH] Risk Assessment, 5-15 minutes, not more often than every 6 months) in the patient... 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
Hospitals report twice as many Part B E/M services in their on-campus outpatient departments compared to services in off-campus outpatient departments. However, overall E/M reporting in outpatient h... More
Question: Can we report G0136 (Administration of a standardized, evidence-based Social Determinants of Health [SDOH] Risk Assessment, 5-15 minutes, not more often than every 6 months) in the patient... 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
Hospitals report twice as many Part B E/M services in their on-campus outpatient departments compared to services in off-campus outpatient departments. However, overall E/M reporting in outpatient h... More
Tools
Make sure your physicians and qualified health care professionals (QHP) are ready for their crucial role in reporting G0136 (Administration of a standardized, evidence-based Social Determinants of Health [SDOH] Risk Assessment tool, 5-15 minutes, not more often than every 6 months).
Use this decision tree to illustrate Medicare’s rules for coding prolonged E/M services. Medicare created codes and rules for prolonged services performed by a physician or qualified health care professional (QHP) because it disagrees with portions of the CPT guidelines.
Benchmark of the Week
Hospitals report twice as many Part B E/M services in their on-campus outpatient departments compared to services in off-campus outpatient departments. However, overall E/M reporting in outpatient hospital settings didn’t drastically change after CMS instituted new place of service (POS) policies in 2016.
Shore up your documentation and strengthen your coding accuracy to ensure your claims aren’t falling into incorrect or fraudulent territory. The Comprehensive Error Rate Testing program under HHS found more than $3.7 billion in improper payments made to a series of E/M services, including more than $660 million in errors for a single E/M office visit code (99214).

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