Tag: Medicare Payments

CMS Unveils Proposed Rules Impacting Medicare Payments for 2025

CMS Unveils Proposed Rules Impacting Medicare Payments for 2025

The Centers for Medicare & Medicaid Services (CMS) has unveiled a series of Medicare payment rules that will dramatically impact Medicare payments for 2025. These changes encompass payment rates, coding guidelines, coverage criteria, and quality measures for various healthcare providers. Physicians, in particular, face a proposed average payment rate cut of 2.93% under the fee […]
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Rural Health Clinic Policies Revised

Rural Health Clinic Billing Updates 2022

The Centers for Medicare & Medicaid Services (CMS) introduced several important Rural Health Clinic (RHC) billing updates that became effective on January 1, 2022. These changes affect Medicare reimbursement, payment limits, telehealth services, care management, hospice services, and mental health billing. Healthcare providers and billing professionals should understand these policy revisions to ensure accurate claim […]
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CMS Releases 2022 Physician Fee Schedule Final Rule

2022 Medicare Physician Fee Schedule

The 2022 Medicare Physician Fee Schedule (MPFS) final rule, released by the Centers for Medicare & Medicaid Services (CMS), introduces several important payment and policy updates affecting physicians, healthcare organizations, and medical billing professionals. Effective January 1, 2022, the rule revises physician reimbursement rates, expands telehealth services, updates Evaluation and Management (E/M) policies, enhances preventive […]
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Lawmakers Seek Changes to No Surprises Act Implementation

Lawmakers Seek ChangNo Surprises Act Implementation

The No Surprises Act implementation has generated significant debate among healthcare providers, insurers, and policymakers. A bipartisan group of 152 members of the U.S. House of Representatives has urged the Departments of Health and Human Services (HHS), Treasury, and Labor to revise the Interim Final Rule (IFR) governing the Independent Dispute Resolution (IDR) process. Lawmakers […]
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Top Challenges of the Merit-Based Incentive Payment System

Top Challenges of the Merit-Based Incentive Payment System

  The Government Accountability Office (GAO) analyzed performance data from providers who participated in the Merit-Based Incentive Payment System (MIPS) between 2017 and 2019 and found that some providers experienced MIPS challenges. Under MIPS, CMS monitors provider performance in four different categories: quality, improvement activities, promoting interoperability, and cost. The providers receive scores in each […]
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The Changing Landscape of Healthcare B2B Payment Transactions

The Changing Landscape of Healthcare B2B Payment Transactions

Healthcare B2B payment transactions have been high in 2021, potentially signaling the importance of electronic payment transfers as the nation emerges from the coronavirus pandemic, according to a report from National Automated Clearing House Association (NACHA). Nacha oversees the ACH Network, a national payment system. B2B payments made through this network in the healthcare industry […]
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E/M Changes Take Effect January 2021

  Good news for physicians tired of counting bullet points to assign an evaluation and management (E/M) level for an outpatient office visit: Per new AMA guidelines, it’s going to be a whole lot simpler. As of January 1, 2021, physicians will select an E/M code based on total time spent on the date of […]
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