The Final Decrease Is Influenced By Add-On Codes and Regulatory Obligations On November 16th, the Centers for Medicare & Medicaid Services (CMS) released the finalized rule for the 2024 Medicare Physician Fee Schedule (MPFS) in the Federal Register. While the policies exhibit several positives, especially in primary care, telehealth, and behavioral healthcare, CMS remains dedicated […]
Healthcare is facing an escalating crisis due to workforce shortages, expected to persist into 2024. This situation has compelled healthcare organizations to operate with constrained resources while grappling with financial strain. Concurrently, healthcare leaders acknowledge the imperative of tackling widening health inequalities and environmental issues to ensure the sustainability and inclusivity of healthcare systems. The […]
Denials within the realm of healthcare persist as a perpetual and escalating issue. By 2022, denials constituted over 11% of claims, posing a significant threat if left unaddressed, as they can severely compromise an institution’s financial well-being and prospects. The combination of outdated technology and manual processes exacerbates the burden on staff, time, and finances […]
Key Performance Indicators (KPIs) within the healthcare revenue cycle play a vital role in monitoring financial well-being and optimizing revenue capture for providers. Understanding these metrics is crucial for healthcare organizations aiming to sustain access to high-quality, cost-effective care—an essential aspect of the evolving landscape of value-based care and healthcare consumerism. These KPIs offer critical […]
The Centers for Medicare & Medicaid Services (CMS) has implemented its proposal to introduce codes for the collection of Social Determinants of Health (SDOH). The latest update for the Healthcare Common Procedure Coding System (HCPCS) Level II, applicable from January 2024, is now accessible on the CMS website. This update comprises significant alterations, including the […]
The 2024 Medicare Physician Fee Schedule, recently released by CMS, confirms the anticipated reduction in payments for physicians. The finalized conversion factor of $32.7442 represents a 3.4% decrease from the 2023 rates, which themselves saw a 2% reduction from 2022. In contrast, the Medicare Economic Index, a gauge of practice cost inflation, surged to 4.6%, […]
While not every policy alteration by the Centers for Medicare & Medicaid Services (CMS) grabs headlines, it’s often these less-publicized changes that lead to the most billing complications. Here are a couple of recent adjustments made by CMS that you might have overlooked. New Place of Service Code CMS introduced a new Place of Service […]
According to a recent report, 25 states now provide reimbursement for video, store-and-forward, and audio-only telehealth, as well as remote patient monitoring through Medicaid. Although every state and Washington, D.C. include some form of live video-based telehealth in their Medicaid programs, only 25 of them also offer Medicaid reimbursement for live video, store-and-forward telehealth, remote […]
In an era where digital progress is transforming every facet of the economy, healthcare is no different. Breakthroughs, particularly in telehealth and e-visits, offer the potential to make healthcare more accessible than ever. While these advancements bring significant promise, they also bring about fresh challenges, particularly in the realm of billing. A growing number of […]
A survey revealed that healthcare organizations anticipate that autonomous coding will accelerate the revenue cycle process and enhance coding accuracy. Although autonomous coding has the potential to streamline revenue cycle processes and alleviate administrative burdens, a majority of healthcare finance leaders surveyed either lack familiarity with it or harbor reservations about fully trusting this automated […]










