Tag: Medicare Reimbursement

Medicare ASC Payment System 2024 Update

Medicare ASC Payment System 2024 Update: New HCPCS Codes & Changes

Medicare payment systems undergo many updates at the beginning of the new year. In the January 2024 update to the ASC Payment System, there are new HCPCS Level II codes for the following ambulatory surgical centers, dentist offices, and durable medical equipment (DME) suppliers: Payments can be passed through covered devices Radiation therapy guided by […]
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Boost Reimbursement with G2211 Add-On Code

Medicare Billing Update: Boost Reimbursement with G2211 Add-On Code

To capture Medicare reimbursement for complex Medicare patient visits, you must know when to use this add-on code. To report the additional time, effort, and related practice expenses associated with caring for Medicare patients across the continuum of care, qualified healthcare providers can begin billing HCPCS Level II codes on Jan. 1, 2024. Evaluation and […]
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2024 Medicare physician fee schedule

Medicare CY 2024 Proposed Rule: Impact, Reimbursement Changes, and Key Insights

On July 13, Medicare released its Proposed Rule, which outlined changes to different Medicare programmes including as quality programmes, MIPS, rural employment, telemedicine, and others. This comprehensive yearly document of 2,033 pages covers the planned programme adjustments for fiscal year 2024. Between the release of the Draft Rule and the publishing of the Final Rule […]
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How Implementing Site-Neutral Policies Can Help Reduce Healthcare Costs

The United States grapples with a healthcare affordability crisis, anticipating a 6.5 percent surge in costs due to inflation next year. Amidst concerns over escalating medical expenses, the deeper roots of these inflated prices often evade attention. Deficient government policies, notably Medicare reimbursement policies, contribute to consolidating the healthcare sector, ultimately driving up costs that […]
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Medicare’s Telehealth Reimbursement Waiver Extended to 2024

The final 2024 Medicare Physician Fee Schedule includes a provision that allows health systems to bill Medicare for telehealth services provided by doctors from their homes. This extension of a crucial Medicare reimbursement for health systems using telehealth services lasts until the end of 2024, and it also grants physicians working from home added privacy […]
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2024 Medicare Physician Fee Schedule: Changes, Impact, and Updates

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%, […]
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Unnoticed Medical Billing Changes in 2023

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 […]
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Challenges in Insurance Reimbursement

Top 4 Challenges in Insurance Reimbursement Faced by Physicians

Access to beneficial healthcare is largely tied to insurance reimbursements for many Americans. Yet, despite their significance, physicians encounter various obstacles in obtaining these payments. Challenges involve inconsistent reimbursement schedules, payment audits, billing errors, unforeseen denials, lengthy appeals, and services falling outside coverage. These issues can hinder timely care, disrupt service continuity, and leave medical […]
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Telehealth Rule Changes

Congress Backs Permanent Telehealth Rule Changes

A new bill pending in Congress could make permanent the telehealth changes that proved beneficial to physicians and patients during the COVID-19 pandemic. Additionally, a leading physician group is now backing site-neutral payment for medical services. These two topics have recently been the subject of renewed discussion due to proposals by federal policy makers. CONNECT […]
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Using Modifier – 25 on an E/M Visit

In recent years, there has been an increase in scrutiny regarding the use of modifier -25 to identify separate evaluation and management (E/M) services on the same day as another procedure. Insurers are now demanding documentation of such services both before and after payment, leading to a significant administrative burden for urology practices. The reason […]
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