Chronic care management (CCM) has an overarching clinical goal—improving the health of Medicare patients with multiple chronic conditions. Besides knowing the service parameters, pay rates and usage requirements for CCM codes, physicians must understand how to effectively bill for CCM in order to profitably achieve that goal. Medicare pays for CCM (typically, non-face-to-face) services to […]
“Incident to” billing by advanced practice registered nurses (APRNs) and physician assistants (PAs) would be eliminated if Congress adopts a recent recommendation from the Medicare Payment Advisory Commission (MedPAC). In its June quarterly report to Congress, MedPAC suggests requiring APRNs and PAs to bill Medicare payment directly for all their services, rather than under the national provider identifier […]
Quality work reduces the burden of the denial management process. When my children were young, they really enjoyed the movie “The Neverending Story.” It’s about a boy who reads a magical book that tells a story of a young warrior whose task is to stop a dark force called “The Nothing” from engulfing a mystical […]
The Centers for Medicare & Medicaid Services (CMS) has removed two Healthcare Common Procedure Coding System (HCPCS Codes) codes just days before the bid window opens. Codes E0992 and K0056 have been dropped from the standard power mobility devices product category as they are only applicable to the standard manual wheelchairs product category. Due to […]
In general, urologists are doing quite well financially. The laws of supply and demand have finally caught up with the profession, as we had predicted years ago. However, you could do better. How can urologists increase their income? In this article, we share with you steps you can take to increase your income, and, at […]
The Medicare Advantage (MA) program, which allows Medicare beneficiaries to voluntarily enroll in a private plan that administers health benefits, was established by the Balanced Budget Act (BBA) of 1997 as a vehicle to bring private-sector competition and innovation to Medicare beneficiaries. When the program was announced, the goal was to create greater competition on […]
The Centers for Medicare & Medicaid Services (CMS) released on June 20 the new ICD-10-CM codes descriptions, tables and index, and addendum for fiscal year 2020. There are 273 additions, 21 deletions, and 30 revisions, effective Oct. 1, 2019, which will increase the code set from 71,932 to 72,184 diagnoses. Chapter Review The majority of changes to new […]
President Donald Trump has signed an executive order that aims to lower healthcare costs by improving price transparency. Seven Things To Know: The order, signed June 24 at the White House, directs HHS to develop rules requiring hospitals to publish prices “that reflect what people actually pay for services in a way that’s clear, straightforward and accessible […]
Patients experienced out-of-pocket increases as high as 12% for their healthcare costs last year, according to a new analysis by TransUnion Healthcare. Technology experts have promised artificial intelligence (AI) and machine learning (ML) will revolutionize healthcare. Applications have the potential to streamline workflows and reduce human errors, speeding drug discovery, assisting surgery, and provisioning better […]
Patients experienced out-of-pocket increases as high as 12% for their healthcare costs last year, according to a new analysis by TransUnion Healthcare. Released this week at the 2019 Healthcare Financial Management Association Annual Conference in Orlando, Florida, the analysis shows increases occurred in all categories including inpatient, outpatient and emergency department (ED) care. Specifically, inpatient care costs […]