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CMS proposes Medicare program for pre-diabetic patients, non-licensed coaches

07/18/2016

CMS is rolling out a service for pre-diabetic patients that you might want to consider as a case partner – or even as a service to take on board at your own practice.

CMS targets prolonged services, epidural injections and more with RVU changes

07/18/2016

by: Part B News staff

Check out CMS’ proposals for relative value units (RVUs) of revised and new codes. CMS included these codes in the proposed 2017 Medicare physician fee schedule as part of its plan to seek public comment on proposed RVUs for new, revised and potentially misvalued codes.

New moderate sedation policy includes new billing rules, 7 new codes

07/18/2016

by: Julia Kyles, CPC-A

Providers who perform services that include moderate sedation will need to report the sedation to get paid in full. Providers who perform stand-alone moderate sedation services will not have to rely on carrier pricing next year, if CMS goes through with changes it announced in the Medicare proposed physician fee schedule.

Pay cuts for film X-rays, review of 0-day global period codes and more in proposed fee schedule

07/18/2016

by: Part B News staff

Part B News has scoured the 856-page proposed 2017 Medicare physician fee schedule and pulled out the notable plans for practices next year. To comment on the proposals, visit www.regulations.gov.

Compare current vs. proposed 2017 payment rates for commonly billed codes

07/18/2016

by: Laura Evans, CPC

The following table shows Medicare professional reimbursement for commonly billed codes at this year’s rates ($35.8043 conversion factor) compared with proposed 2017 proposed rates, including revisions to relative value units and the revised conversion factor of $35.7751. Payment rates are compared for both the facility and non-facility setting. All fees are par, not adjusted for locality.

Add Medicare Advantage patients to your CCM rolls – when they’re covered

07/11/2016

by: Richard Scott

Check the fine print on your payer contracts, because you may be able to bill your Medicare Advantage carriers when you provide chronic care management (CCM) services to patients covered under these non-traditional Medicare plans.

Write, revisit BAA policies that protect you when associates mess up HIPAA

07/11/2016

by: Roy Edroso

A recent Office for Civil Rights (OCR) settlement that fixes responsibility for a HIPAA breach on a business associate underlines the importance of making sure you have proper, current and well-managed business associate agreements (BAAs) for every relevant vendor.

CMS proposes 90-day meaningful use period for 2016, off-campus provider pay cuts

07/11/2016

by: Richard Scott and Laura Evans

You may be able to forget the full-year reporting requirement for meaningful use this year if a proposed rule issued July 6 becomes final.

Avoid improper billing; extend professional courtesy as ‘all or nothing’

07/11/2016

by: Roy Edroso

If you want to continue the longstanding tradition of doctors treating doctors for free, be prepared to spend big on it — or don’t do it at all.

CMS proposes changes to clear jam at some appeals levels

07/11/2016

by: Roy Edroso

A new proposed rule from HHS attempts to clear some deadwood from the third and fourth level of Medicare appeals and reduce the absurd backlog at those levels.

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