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CMS proposes changes to Medicare Advantage scoring, new and revised HCCs

01/08/2018

If you serve mental health or nephrology patients on Medicare Advantage plans, take notice of a CMS proposal to change Medicare Advantage risk adjustment.

Limit post-op billing when provider changes practices during global period

01/08/2018

by: Richard Scott

Question: A surgeon performs a procedure at one practice location. He then leaves that practice, transitioning to a new practice during a patient’s 90-day global period. The second practice is an entirely new group with a new tax ID. When the physician starts at the new practice and sees his patient from the first practice for routine follow-up care, how do we report those post-op visits? Can they be reported separately?

E/M use for top M.D.s dropped in 2016 — but NPPs’ use rose

01/08/2018

by: Roy Edroso

Top specialties saw office E/M utilization go down between 2014 and 2016, the most recent year for which we have Medicare data — except for the two top-billing categories of non-physician practitioners (NPP).

From the Part B News blog

01/08/2018

by: Richard Scott

Take note of the news that happens between Part B News issues by checking out the free Part B News blog. Here’s a sampling from this week.

2018 Correct Coding Initiative Policy Manual

01/01/2018

by: Correct Coding Initiative

Providers take on risk, OCR goes after ‘juicy’ violations, MIPS habits change and more

01/01/2018

by: Roy Edroso and Richard Scott

Part B News editors surveyed readers and interviewed experts to come up with 11 predictions of what will affect physician practices in 2018. Find out what's in store with a look as Medicare Advantage is expected to expand, the merit-based incentive payment system (MIPS) may get tougher and more.

PBN’s 2017 predictions: Right on QPP, CCM, fraud — and almost everything else

01/01/2018

by: Roy Edroso and Richard Scott

Part B News did well, if we do say so ourselves, in its predictions for health care in 2017, though it’s too early to tell the results in some cases. Here’s a round-up of how we did.

Survey says: Part B News readers going for the gold in MIPS 2018

01/01/2018

by: Roy Edroso

CMS will allow merit-based incentive payment system (MIPS) participants to turn in a minimum amount of data to avoid penalties, but Part B News’ 2018 Predictions Survey shows practices are far more likely to go for a positive payment adjustment. And a surprising number appear to be involved in value-based care models.

Hundreds of lab codes expected to earn less revenue in 2018 as cuts take hold

12/18/2017

by: Richard Scott

If your practice performs lab tests, you may be in for a dose of sticker shock in 2018 as hundreds of codes are expected to see reduced payments under a Medicare fee-schedule change.

MedPAC reaffirms opposition to MIPS, support of APMs; will Congress heed?

12/18/2017

by: Roy Edroso

The Medicare Payment Advisory Committee (MedPAC) again called to get rid of the merit-based incentive payment system (MIPS) and replace it with a program more tailored toward pushing providers into alternative payment models (APMs).

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