The COVID-19 pandemic has proven that fast, meaningful change is both possible and necessary for healthcare revenue cycles to keep up with a changing world. But to make truly meaningful change within the revenue cycle, the industry will need to embrace even more changes, such as payer partnerships, greater automation, and standardization across payers. Payer-provider […]
The Centers for Medicare & Medicaid Services (CMS) in the past week has proposed Medicare payment rules for outpatient services and physicians for 2021 and finalized payment rules for inpatient rehabilitation facilities (IRFs) and psychiatric facilities. Looking specifically at the 2021 Physician Fee Schedule (PFS) proposed rule, scheduled to be published Aug. 17, it […]
Although the integration of big data into health care has been increasing in recent years, the coronavirus disease 2019 (COVID-19) pandemic has brought this practice to the forefront, as many hospitals and care facilities struggle to keep accurate and timely records of COVID-19 cases while adhering to changing procedures implemented at the federal level. “The use of […]
A work group put together by the American Medical Association (AMA) that also represents the AMA’s Current Procedural Terminology (CPT) Editorial Panel and the AMA/Specialty Society RVS Update Committee (RUC) has put together revisions to office and outpatient evaluation management (E&M). These will take effect on January 1, 2021. So how will this affect dermatologists? Well, […]
The COVID-19 pandemic has brought about robust changes to the traditional practice of healthcare in the United States. In a time of social distancing and widespread quarantining, regulatory bodies, including the Centers for Medicare & Medicaid Services (CMS), have adapted to the current environment. The most critical goal was to allow healthcare providers to […]
Coders should also take note of the new HCPCS Level II codes CMS is considering. CMS released the calendar year (CY) 2021 Medicare Physician Fee Schedule (MPFS) on August 3, introducing 39 new CPT codes, mainly for cardiovascular services. If finalized, the new codes will go into effect January 1, 2021. The proposed update includes five new codes for […]
The rapid rise of telemedicine in response to the COVID-19 outbreak has been critical for getting at-risk patients the care they need. In fact, many state governments are working to expand telehealth within their Medicaid programs, while also easing restrictions to allow for faster implementation. And there is evidence that this trend will not be reversed anytime soon. […]
The American Medical Association (AMA) has recently expanded its Current Procedural Terminology (CPT) code set to include four additional codes for coronavirus testing. These new codes facilitate providers in reporting a wider range of laboratory tests for the novel coronavirus on medical claims. The newly introduced CPT codes are as follows: •86408: SARS-CoV-2 neutralizing antibody […]
Know what to look for when auditing telehealth services rendered during the COVID-19 pandemic. In October of 2019, I presented a telehealth webinar entitled “Foolproof Tips for Billing Telehealth Services.” I talked quite a bit about the telehealth guidelines that were current at the time and made note that “by next year, telehealth is expected […]
Provider reimbursement is now available to physicians who tell their patients to self-isolate at the time of COVID-19 testing, according to CMS. An announcement released late last week in collaboration with the Centers for Disease Control and Prevention (CDC) said CMS will leverage existing evaluation and management (E/M) payment codes to reimburse eligible providers for the coronavirus […]