CMS will expand its value-based purchasing initiative this year, starting with more physician resource use feedback (PRUF) reports, which you'll simply get automatically without any action on your part. The expanded PRUF reports are another step toward the eventual implementation of a new payment modifier, which will change your Medicare reimbursement based on the quality and cost of the care you provide to patients.

When your practice sees denials for global services done in an ambulatory surgical center (ASC), check to make sure you don't miss out on a professional component payment your practice is entitled to under Medicare rules.

Your patients should have a choice of whether to receive Medicare's new annual wellness visit or the current Welcome to Medicare visit during their first 12 months of Medicare eligibility, according to comments filed by the American Academy of Family Physicians (AAFP) in response to the proposed 2011 Medicare Physician Fee Schedule.

You'll soon have a forum to appeal a CMS decision to deny you a Physician Quality Reporting Initiative (PQRI) bonus. CMS proposes in the 2011 Medicare Physician Fee Schedule (PBN 7/12/10) to establish an informal appeals process through the program's Quality Net Help Desk starting in 2011. Here's how you do it.

You and your patients got some good news from the new health reform law when it comes to dealing with health plans - it will be easier for you to appeal adverse decisions from health plans and new appeal rights will be afforded.

You and your peers have flooded CMS with questions on how to demonstrate meaningful use of electronic health records (EHR) systems in order to score up to $44,000 per provider in federal incentives. The agency has compiled a list of the 10 most common questions "that don't have immediately obvious answers," according to one official. Here's a partial rundown.

Your peers across the country took measures large and small to tighten their belts and boost efficiency in the face of this year's pay-fix saga and the extended debate and passage of health reform. However, many subscribers tell Part B News they won't touch the nuclear option of refusing to see new Medicare patients.

Can you give me billing guidelines for how to bill polysomnography code 95810 ($766.22) when the service is done in the hospital? Is it automatically a global code?

This chart compares nine specialties with some of the highest Medicare utilization, to see how their billing breaks down by code category. The data lets you see at a glance where a specialty's utilization comes from, whether it's E/M services (99201-99499), imaging and radiology (70000-79999), lab tests (80000-89999), medicine and therapy (90281-98962) or surgery and anesthesia (00100-69990). All statistics are based on CMS claims data from 2008, the latest available.

The prize of $44,000 per physician for meeting meaningful use via Medicare's Electronic Health Record (EHR) incentive program is more accessible than you might think. Physicians who can't meet any clinical quality measures - because none are relevant to their practices - are still eligible for the full EHR bonus, assuming they meet all other requirements and get started by the cutoff date of Oct. 1, 2012.