What are the latest code changes? Get the facts, fast. This month, there’s new billing guidance for a COVID-19 vaccine; there are three new HCPCS Level II codes for COVID-19 therapeutic injections; and Medicare payment allowances for the 2021-22 influenza vaccine codes have been released. FDA Approves COVID-19 Vaccine Pfizer’s COVID-19 vaccine received the […]
On Aug. 2, 2021, the Centers for Medicare and Medicaid Services (CMS) posted the fiscal year (FY) 2022 Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule. Effective Oct. 1, the final rule updates Medicare payment policies and quality reporting programs for inpatient and long-term care hospitals […]
Medicare will pay an additional reimbursement of about $35 per dose administered for up to a maximum of five vaccine administration services per home unit or communal living space, as long as it is in a single group living location, CMS posted on its website earlier today. The payment boost means that Medicare will […]
The need to improve patient access to mental and behavioral health services is undeniable, and tools from the AMA and others are available to help primary care practices integrate these services into their workflow and ensure they are properly paid for these services. When North-western Medicine needed to provide greater access to behavioral health services […]
Practices have been creative during COVID-19 to ensure safe patient access: Telephone visits. Curbside immunizations. Drive-up virus testing. Even checking patients in for their in-office visits while they wait in the car. However, each of these scenarios poses one significant challenge: Collecting copayments and coinsurance. “With COVID-19, you’ve got to find ways to meaningfully engage […]
Telehealth is hot right now among physicians and patients, but what’s its long term outlook? What impact will telehealth have on patient outcomes and physician reimbursement? Telehealth is hot right now among physicians and patients, but what’s its long term outlook? What impact will telehealth have on patient outcomes and physician reimbursement? To learn more […]
The COVID-19 outbreak appears to have impacted claims patterns for Medicare Advantage enrollees, according to a new analysis by Avalere Health. Even though seniors are historically the most vulnerable population health-wise, their claims were down dramatically during the month of April. The survey suggests it could impact risk score factors for MA plans in 2021, driving […]
Every year, the Trends in Healthcare Payments Annual Report is distributed to start a conversation about the current state of the industry and shine a light on areas where change is needed. For healthcare providers, the report has consistently found that more of their revenue is dependent on out-of-pocket payments from consumers and less is covered […]
Hospital and health system executives should monitor these proposals for provisions that will affect their organizations’ operations. The 2020 annual rule cycle has been active for CMS. Several proposals in the outpatient prospective payment system (OPPS) proposed rule is controversial, although there is at least one provider-friendly change. Here’s a roundup of five regulatory rules […]