Tag: Physician Fee Schedule


Time is Running Out for Congress to Help Primary Care

Time is running out for Congress to take action on pending legislation dealing with issues that would help primary care across the United States. Six physician groups representing 590,000 doctors across the country sent a joint letter again urging congressional leaders to vote – soon – for bills relating to Medicare reimbursements, prior authorizations, children’s […]
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Highly Anticipated 2023 Medicare Final Rules Published

The final rules become effective Jan. 1, 2023. Amid this election season, the Centers for Medicare & Medicaid Services (CMS) has published final rules for the 2023 Part B Physician Fee Schedule and Medicare Shared Savings Program, the Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment System, the End-Stage Renal Disease (ESRD) Prospective […]
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2023 MPFS and Quality Payment Program Final Rule Released

The conversion factor is down but certain public health emergency flexibilities will continue. The 2023 Medicare Physician Fee Schedule (MPFS) and Quality Payment Program final rule, released Nov. 1, allows Part B physician payment for behavioral healthcare, cancer screening, and dental care. But while the Centers for Medicare & Medicaid Services (CMS) continues its focus […]
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CMS Releases Physician Fee Schedule Final Rule

CMS says it the goal is to support health equity while focusing on high-quality person-centered care. Increased leverage of telehealth for behavioral care, diabetes prevention and mitigation, and enhanced payment for vaccine administration were three out of many priorities cited by federal officials who announced the release of the Centers for Medicare & Medicaid Services […]
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CMS Faces Calls to Improve Remote Patient Monitoring Coverage in 2022 PFS

Telehealth advocates are submitting recommendations to CMS to improve coverage for remote patient monitoring services in the proposed 2022 Physician Fee Schedule. With remote patient monitoring projects surging in popularity as a result of the pandemic, telehealth advocates are lobbying the Centers for Medicare & Medicaid Services to improve proposed coverage plans in the 2022 […]
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CMS to Reprocess Some Outpatient Claims After Site-Neutral Ruling

CMS has announced that it will reprocess hospital outpatient claims from last year for clinic visit services provided at excepted off-campus provider-based departments. The agency will start reprocessing the claims in July 2021 in order to pay all hospitals the same rate as non-excepted off-campus provider-based departments for clinic visit services paid under the Physician Fee Schedule, […]
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Final Physician Payment Rule Keeps E/M Code Changes

CMS on Friday issued its 2020 final rules for the Physician Fee Schedule, including a streamlining of evaluation and management services (E/M) reporting that was rolled back from an earlier proposal in a change providers applauded. The final rule, which is mostly unchanged from the proposed rule put forward in July, also cuts payments to physical therapists […]
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MEDPAC Calls For End To ‘Incident To’ Billing

“Incident to” billing by advanced practice registered nurses (APRNs) and physician assistants (PAs) would be eliminated if Congress adopts a recent recommendation from the Medicare Payment Advisory Commission (MedPAC). In its June quarterly report to Congress, MedPAC suggests requiring APRNs and PAs to bill Medicare payment directly for all their services, rather than under the national provider identifier […]
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