Part B News
See why it’s vital to capture history and exam during E/M encounters
08/25/2025
by: HCPro staff
Question: What role do the history and exam play in determining the level of an evaluation and management (E/M) service? Are they optional?
Prescription Rx management documentation must show MDM, risk
08/18/2025
by: Julia Kyles, CPC
Make sure your providers are showing the mental work that goes into evaluating the risk associated with a medication before you count it toward the risk element of an E/M visit that is coded based on medical decision-making (MDM).
Survey: Docs leave practices even when satisfied; time for retention nudge?
08/18/2025
by: Roy Edroso
Everyone seems to agree that “job satisfaction” is an important factor in retaining employees, including clinical staff at a physician practice. But what if the staff are satisfied with their jobs — yet still more than willing to leave?
Avoid penalties, take a more proactive approach to risk analysis
08/18/2025
by: Dom Nicastro
A recent settlement between the Office of Civil Rights (OCR) and Health Fitness Corporation offers a sharp reminder of the steep consequences of neglecting HIPAA Security Rule compliance, especially the risk analysis requirement that underpins effective protection of electronic protected health information (ePHI).
Few outpatient hospital E/M claims, but they beat the denial spread
08/18/2025
by: Roy Edroso
The small number of outpatient E/M codes (99202-99215) performed in hospital outpatient clinics and claimed with the outpatient place of service (POS) codes saw only modest growth in 2023. But they had better denial rates than you might expect.
Investigate all three RVU amounts for accurate pay predictions
08/11/2025
by: Julia Kyles, CPC
A Part B News subscriber’s question about telemedicine payments, and the release of the proposed 2026 Medicare physician fee schedule, contain lessons that apply to all services: Check the relative value units for services you commonly report every year. And while you’re at it, look at the calculations for new services you plan to perform.
Pushed on all sides, Medicare Advantage plans make pledges on prior authorization
08/11/2025
by: Roy Edroso
The struggle against prior authorization in Medicare Advantage has raged for years, but a new wave of voluntary self-reforms by payers suggests that patient, payer and government pressure may be forcing some reforms.
Could USPSTF cuts be a threat to Medicare preventive payments?
08/11/2025
by: Roy Edroso
The Affordable Care Act authorizes the U.S. Preventive Services Task Force to make recommendations that result in no-cost preventive services coverage for beneficiaries of Medicare and other plans. But conflict between the Task Force and HHS Secretary Robert F. Kennedy Jr. may disrupt that process.
OIG global surgery billing report reminds practices to check their coding compliance
08/11/2025
by: Julia Kyles, CPC
Payments for services during the global surgery period remain a hot-button issue and the data collection program CMS implemented in 2017 is back in the spotlight, thanks to a July 1 report by the HHS Office of Inspector General. The OIG spelled out its conclusions in the July 1 report titled “CMS Should Improve Its Methodology for Collecting Medicare Postoperative Visit Data on Global Surgeries.”
Sudden impact: Proposed payment chart highlights CMS’ pay plans
08/11/2025
by: Julia Kyles, CPC
CMS has big plans for your Part B payments in 2026. For example, it wants to restructure reimbursement to favor services performed in non-facility settings, such as the office, and slash payments for services performed in the facility setting.
Prev Next

Login

User Name:
Password:
Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.
Quick Links
Learning Opportunities
See more...
Forum

The Forum is temporarily unavailable.

click icon to expand
Back to top
Privacy Policy
|
Terms of Use
|
© 2026 DecisionHealth, an HCPro Brand