Tag: MIPS

Therapy Services Codes

Therapy Services Codes: A Complete Guide to CPT & HCPCS Codes

Therapy services play a vital role in healthcare, helping patients recover from injuries, manage chronic conditions, and improve overall well-being. To ensure accurate billing and reimbursement, healthcare providers must use the correct therapy services codes. These codes, primarily based on the Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), help standardize claims […]
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Medicare Physician Fee Schedule 2025: Urology Practice Impact

urology practices: The Centers for Medicare & Medicaid Services (CMS) unveiled its proposed Medicare Physician Fee Schedule for 2025 on July 10, 2024. This outlines potential payment adjustments and policy changes that would take effect starting January 1, 2025. A public comment period will follow, during which CMS will gather feedback to inform the final […]
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Medicare Payment Cuts Hit Physicians: 2.93% Reduction in 2025

Medicare Payment Cuts Hit Physicians: 2.93% Reduction in 2025

Medicare payment cut: The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule for the 2025 Medicare Physician Fee Schedule (MPFS), which includes a 2.93% average payment rate reduction for physicians. This comes despite the agency’s stated commitment to advancing health equity and supporting whole-person care through initiatives like strengthening primary care […]
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Understanding 2021 Changes in Emergency Medicine Reimbursement

Understanding 2021 Changes in Emergency Medicine Reimbursement

  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 […]
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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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2021 E_M Guideline and Leveling Changes

2021 E/M Guideline and Leveling Changes

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 […]
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2021 Telehealth Reimbursement

CMS Outlines Telehealth Reimbursement for 2020-21 eCQM Programs

  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 […]
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Quality Payment Program In Clinical Trials

Coronavirus: CMS Urges Use Of Quality Payment Program In Clinical Trials

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 […]
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