On November 2, 2022, the Centers for Medicare & Medicaid Services (CMS) issued CY 2023 Physician Fee Schedule Final Rule (Final Rule), implementing certain updates and policy changes for Medicare payments under the Physician Fee Schedule (PFS) and changes to the Medicare Shared Savings Program (MSSP), effective on or after January 1, 2023. The final […]
Emergency medicine groups face several changes this year, including a new federal ban on surprise medical billing, updates to the Medicare reimbursement formula, changes to the CMS MIPS program, and new billable services. Below is a summary of these changes provided by the experts at Brault Practice Solutions. Federal Ban on Surprise Medical Billing At […]
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 […]
The AMA is warning the Centers for Medicare & Medicaid Services (CMS) that rate-cutting provisions in its proposed 2021 Medicare physician payment schedule pose “a very real threat to the ability of many physicians to deliver health care services to their patients.” CMS has proposed new office-visit policies that should result in a significant reduction […]
Doctors looking to earn more under Medicare’s Merit-based Incentive Payment System (MIPS) would likely benefit from working in a practice affiliated with a hospital system. A recently-published study in JAMA finds that doctors in system-affiliated practices earned substantially higher MIPS scores in 2019 than those in independent practice, and were thus more likely to receive upward payment adjustments and […]
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 2019, […]
Providers need a mechanism to be accurately reimbursed for the time and effort that they expend in providing care. Evaluation and Management (E/M) leveling has been the standard method in which to provide appropriate, defensible payments for services. However, it has been successfully argued that the 1995 and 1997 E/M guidelines in place today are […]
The documents released earlier this month offer details on 42 eCQMs for telehealth services during the 2020 performance period and 39 eCQMs for telehealth services during the 2021 performance period. The Centers for Medicare & Medicaid Services has released additional details on telehealth reimbursement through quality reporting programs for the 2020 and 2021 performance periods. […]
CMS is now offering MIPS credit for all participating clinicians of the Quality Payment Program to help report and provide COVID-19 data. The Centers for Medicare & Medicaid Services (CMS) is asking all clinicians in the Quality Payment Program (QPP) to contribute to the scientific research and reporting efforts to help curb the spread of […]
The Centers for Medicare & Medicaid Services (CMS) is pushing clinicians to participate in the Quality Payment Program to contribute scientific research and evidence to aid in the fight against the COVID-19 coronavirus pandemic. According to a news release, those who participate in COVID-19 clinical trials and report information may now earn credit in the Merit-based […]