If all the documentation requirements are met for a certain level of service, but the medical necessity of the visit is less than that required for a particular level, bill the lower level?  Who is determining the medical necessity of each level and how is it determined?

Non-physician practitioners (NPPs) in imaging and radiology will see the same pay cuts as their specialty providers despite CMS’s projections that nurse practitioners (NPs) and physician assistants (PAs), in general, would see a pay gain during the dataset transition for calculating reimbursement rates, experts say.

Your non-physician practitioners (NPPs) have been billing more and more smoking cessation services, though denials remain surprisingly high. Cutting denials and focusing on this fast-growing service could be even more important in 2012,because smoking cessation would become billable as a telehealth service under the 2012 Medicare Physician Fee Schedule (PFS) proposed rule, an NPP Report analysis shows.

These charts look at how top-billed codes by non-physician practitioners (NPPs) would be impacted by relative value unit (RVU) changes in the proposed 2012 Medicare Physician Fee Schedule (PFS).

Q. Our practice is looking into hiring an NPP, and can’t decide whether to hire an advanced registered nurse practitioner (ARNP) or a physician assistant (PA). Any advice you can offer?

You must use your electronic health record (EHR) system to transmit patient data, either to another EHR-equipped provider or to public health agencies, in order earn your $18,000 first-round incentive payment – but complying with these measures are often the toughest parts of demonstrating meaningful use, experts say. Follow these tips to get it done and collect the $18,000 check.

Your specialty would get its own reporting criteria for the Physician Quality Reporting System (PQRS) program, according to a Part B News analysis of the many PQRS changes in the 2012 proposed Physician Fee Schedule (PFS). CMS wants to create separate reporting criteria and more measures for specialists, tailoring the way you participate in PQRS on your specialty.

If your state still allows balance billing and you’re not on a particular payer’s network, you can still balance bill members of that payer. But the atmosphere for doing so may be less conducive than in the past. Take these steps to protect yourself when balance billing.

You won’t be able to complete the Medicare enrollment or revalidation process via the online Provider Enrollment Chain and Ownership System (PECOS) if you have not yet received your updated advanced diagnostic imaging technology accreditation from one of three CMS-approved accrediting bodies. Your best bet is to switch to paper now or wait for a bug fix from CMS to continue, experts say.