Tag: MACRA

The 3 Policies Controlling Physician Reimbursements

The 3 Policies Controlling Physician Reimbursements

Three big CMS moves have affected physician reimbursements in the last 10 years, according to VMG Health’s 2023 mergers and acquisitions report released on March 21: Here are the three CMS policies: In April 2015, the Senate passed the Medicare Access and CHIP Reauthorization Act, which permanently removed the sustainable growth rate formula under the […]
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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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Clinicians Serving Socially At-Risk at a Disadvantage Under MIPS

Clinicians Serving Socially At-Risk at a Disadvantage Under MIPS

  Clinicians who served more patients with social risk factors such as low income performed worse in the Merit-Based Incentive Payment System’s inaugural payment year, and therefore, received unfavorable value-based reimbursement, according to a new study. The study recently published in Health Affairs found that out of 510,020 clinicians participating in the Merit-Based Incentive Payment System (MIPS) in […]
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Medicare Beneficiary Identifiers

The New Medicare Cards: What You Need to Know About Medicare Beneficiary Identifiers (MBIs)

To protect the privacy of Medicare recipients and prevent fraudulent use of Social Security Numbers (SSN), a new, unique 11-character Medicare Beneficiary Identifier (MBI) is replacing the SSN-based Health Insurance Claim Number (HICN) for Medicare transactions such as billing, eligibility status, and claim submissions. The MBI does not change Medicare benefits. What’s Behind The Change? The […]
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HCPCS and CPT Codes

What’s New In 2019 For CMS

This year’s reporting for the Quality Payment Program will affect the 2021 payment year. Kevin J. Corcoran, COE, CPC, CPMA, FNAO, delivered his annual update at Hawaiian Eye 2019, highlighting changes CMS would be making this year for coding, payment issues, regulatory matters, administrative issues and reimbursement issues. The Medicare Physician Fee Schedule did not […]
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MACRA Readiness for Healthcare Organizations

MACRA Readiness for Healthcare Organizations

Without even putting too much effort into listening to or reading the news, you understand that healthcare costs have steadily risen over the last couple decades, and yet we don’t really have any significant and correlating rise in outcomes to show for it.  CMS or the Centers for Medicare and Medicaid Services has also noticed […]
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