When you're not sure if services done by an expensive diagnostic machine will stay well-paid and in demand, you're better off leasing the machine (see Buy or Lease Equipment story). But the hard choices don't stop once you decide to lease. There's plenty of things you can do to ensure a good lease that minimizes the financial risk of signing a contract lasting years, experts say.

Don't expect to see big price swings in the fourth quarter for a lot of the drugs you bill, but as always a handful of CMS payments will see double-digit changes starting Oct. 1. A Part B News analysis also shows large shifts in price during 2009 among the roughly 590 drugs found on the Average Sales Price (ASP) list for Part B drugs, which sets your practice's payments for drugs such as injectables.

Beware: Your computer may be or already has been attacked by "rogue ware," the latest and one of the most aggressive, fastest-growing cybercrimes. Rogue ware operates like this: You get an "urgent" message saying your computer has a virus and you can buy software to eradicate the virus for a price typically between $49.95 to $79.95

Consider an alternative Physician Quality Reporting Initiative (PQRI) reporting option in 2010 if you are unsatisfied with claims-based reporting (see PQRI claims-based reporting story).

This week's Benchmark of the Week shows changes in payment for 10 of the most frequently billed drugs on CMS's Average Sales Price (ASP) list from 2006 to 2009. Most of these drug codes are used for common conditions such as asthma, cancer and renal disease; the three big losers, with double-digit percent drops, were all for albuterol or levalbuterol.

You may soon have the opportunity to screen Medicare patients for HIV when your physicians believe the patient might have the virus or have risked contracting it.

If an established patient has not visited the office in a couple of years, when can he/she be considered "new" at the next visit? What extra documentation should we include with the first claim?

Get your new non-physician practitioner (NPP) acclimated to your practice by using these five transition strategies. Your peers say the transition is slow at first, but the NPP can better help your practice manage your current patient base and help you expand. 

In other words, the greater an NPP's compensation to collections ratio, the smaller the amount of revenue earned by the practice as a result of the NPP's work. This means that the NPPs on the low end - like physical therapists and PAs who work in family practices - provide the most revenue to the practice, says David Litzau, survey analyst for the MGMA in Denver. 

The three top earners - certified registered nurse anesthetists (CRNAs), chiropractors and surgical physician assistants (PAs) - each hit triple digits. Physical therapists were paid the least on average.