Part B News
CMS delays start of Radiation Oncology Model by six months
11/09/2020
by: Sarah Gould
CMS recently announced that it intends to delay the launch of the new Radiation Oncology Model (ROM) to July 1, 2021 instead of Jan. 1, 2021. The decision comes after stakeholders commented that a January start date would place an unfair burden on providers already challenged by staff shortages.
Medical practice pay up prior to COVID; telehealth takes hold
11/09/2020
by: Richard Scott
The COVID-19 public health emergency (PHE) hasn’t made it easy, but medical practice personnel have a lot to be proud of this year, including steady pay gains, new responsibilities on the job and the mettle to meet a once-in-a-century pandemic with steely resolve.
COVID disrupts salary gains, challenges medical practice business ops
11/09/2020
by: Richard Scott
In the wake of the COVID-19 public health emergency (PHE), medical practices have confronted — and continue to grapple with — a barrage of business, financial and staffing repercussions, all of which are leaving practice staffers with unprecedented shake-ups in their day-to-day roles.
QPP 2019 wrap: High participation and scoring rates but low bonuses
11/09/2020
by: Roy Edroso
On Oct. 27, CMS released preliminary figures on 2019 participation in the Quality Payment Program (QPP) and the Merit-Based Incentive System (MIPS). More than 97% of eligible clinicians (EC) took part in MIPS that year, as did 85.2% of eligible small practices.
Final price transparency rule announced
11/09/2020
by: Roy Edroso
On Oct. 29, CMS announced a final rule on transparency coverage requiring insurers to provide accurate prices for health care procedures.
COVID vaccine, therapeutics rule issued
11/09/2020
by: Roy Edroso
On Oct. 28, HHS announced an interim final rule with request for comments. The rule, issued by HHS, the U.S. Departments of Labor and the Treasury and the IRS, calls for all health care payers to offer a COVID-19 vaccine, when it becomes available via FDA authorization, as a Medicare preventive vaccine without cost-sharing.
Review advance care planning charts before OIG starts its audit
11/09/2020
by: Julia Kyles, CPC
Check the time and other possible billing hazards for advance care planning (ACP) claims. The two ACP codes (99497, 99498) show an average denial rate of 19% since Medicare started covering the service, which may be a sign that practices are making easy-to-avoid mistakes for the two codes.
Booming interest in behavioral health integration signals a new opportunity for practices
11/02/2020
by: Roy Edroso
A new multi-organizational collaborative is proving further evidence of the growing interest in behavioral health integration (BHI) with primary care. While reimbursement for integration is unsteady at present, signs suggest this will become a larger and better compensated part of your practice in the years to come — if you’re prepared to implement it.
Tackle CPT coding challenges and ICD-10-CM updates for behavioral health
11/02/2020
by: Sarah Gould
Get a crash course on coding for behavioral health services, which can be tricky given number of conditions that influence mental well-being. Providers must tailor evaluations and interventions to individual needs and adhere to medical necessity standards when billing for services under Medicare.
Narrow your focus: Even if you meet the NCD, missing LCD could cost you
11/02/2020
by: Roy Edroso
A recent OIG investigation, and over $300,000 in potential paybacks, serves as a reminder to check your local as well as your national coverage determination (NCD) before performing and billing Medicare for bariatric weight-loss surgery — or anything else.
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