CMS: Pay Attention to Telehealth Billing Rules

CMS recommends that organizations review the agency’s most recent guidance on telehealth billing. CMS is reminding providers to ensure that Medicare claims for telehealth are correctly billed. The agency issued broadly expanded telehealth services as part of its response to the COVID-19 public health emergency. However, a 2018 Office of Inspector General audit found that CMS paid […]
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CMS Issues Proposed Rules Set to Affect Hospices, SNFs

Both rules would do more than merely impact payment. Federal officials this week unveiled a pair of proposed rules that are likely to have significant ramifications for hospice and skilled nursing facility (SNF) providers nationwide. Centers for Medicare & Medicaid Services (CMS) rules 1754-P and 1756-P were issued on Thursday, along with lengthy fact sheets […]
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Congress Provides Relief on Medicare Payment; Passes Surprise Billing

The $1.4 trillion omnibus legislative package passed by Congress late Monday includes COVID-19 related relief for physicians, imposes new restrictions on surprise billing, and funds the government through fiscal 2021, which ends Sept. 30. The legislation mitigates budget neutrality cuts that would have slashed physician Medicare payment rates by 10.2% and extends the moratorium on the budget […]
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2021 Physician Fee Schedule

Expect Give and Take in 2021 Physician Fee Schedule

After a slight delay, the Centers for Medicare & Medicaid Services (CMS) has finalized 2021 payments and policies under the Medicare Physician Fee Schedule (PFS). Most notably, the final rule makes permanent several telehealth flexibilities introduced during the public health emergency (PHE) for the COVID-19 pandemic while also significantly overhauling reimbursements for many services related […]
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HHS Proposes HIPAA Modifications

The Department of Health and Human Services on Thursday unveiled proposed changes to the Health Insurance Portability and Accountability Act Privacy Rule that federal officials say will improve patient access to their medical records, encourage coordinated care and cut red tape. “Our proposed changes to the HIPAA Privacy Rule will break down barriers that have stood in […]
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How Urology Coding Changed In 2020

As 2020 winds down, typically everyone from newscasters to sports reporters to anyone with a Twitter handle will write a “Year in Review” article, adding their predictions for the upcoming year. So we thought we would do the same – take a look back and also a look ahead. 2020 has been a fascinating year. […]
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Physician Billing For Wound Care Services Rendered Via Telehealth

When billing for outpatient telehealth services during the COVID-19 PHE, providers should use the POS code that they would have otherwise used had the service been provided in person. Q: What place of service (POS) codes and modifiers should be reported on physician claims for wound care services performed via telehealth during the novel coronavirus […]
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CMS Provides Medicare Reimbursement for More Telehealth During PHE

CMS recently added 11 new services to the Medicare telehealth services list, qualifying the services for Medicare reimbursement through the COVID-19 public health emergency (PHE). The new telehealth services cover some cardiac and pulmonary rehabilitation services, as well as certain neurostimulator analysis and programming services. The additions to the Medicare telehealth list were made in […]
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