Medicare Telehealth Policy Changes are set to reshape the landscape of telehealth services. As the COVID-19 public health emergency ends, Medicare will revert to pre-pandemic policies, imposing stricter rules for telehealth services starting January 1, 2025, unless Congress intervenes. Key changes include: Geographic Restrictions: Patients must generally live in a health professional shortage area, a […]
The Centers for Medicare & Medicaid Services (CMS) recently announced plans to continue allowing certain telehealth flexibilities beyond the end of 2024. These changes are part of their proposed rules for Medicare payments in 2025. While most temporary telehealth rules from the COVID-19 pandemic are set to expire, CMS wants to keep some in place. […]
Understanding Modifier 95: A Brief Overview Modifier 95 is a medical billing code used to indicate that a service was provided via telehealth. This modifier is essential for ensuring that healthcare providers receive appropriate reimbursement for remote services. Here are the key points about Modifier 95: Purpose: Modifier 95 is appended to the CPT or […]
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 […]
On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2025. The calendar year (CY) 2025 PFS proposed […]
Telehealth billing, the process of submitting claims for telehealth services, is an essential component of this virtual care model. Efficient and accurate telehealth billing ensures that providers are reimbursed for their services and that patients are not overbilled. The healthcare landscape has undeniably shifted towards a more virtual model. Telehealth, the utilization of telecommunications technology […]
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%, […]
Telehealth has gained widespread acceptance among numerous medical practices and hospitals owing to its convenience, accessibility, and effectiveness in curbing the spread of infectious diseases. However, it’s important to recognize that telehealth is not exclusive to large institutions; small practices can also reap its benefits. Telehealth, also known as telemedicine, revolves around utilizing technology to […]
On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule seeking public feedback on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues. These changes are set to take effect on or after January 1, 2024. The proposed rule for […]
The 2024 Medicare Physician Fee Schedule proposal includes a reduction of 3.4% to the conversion factor that determines Medicare payment rates. This reduction will widen the gap between practice expenses and reimbursement. If the proposal is approved, the new conversion rate will be $32.7476. Here are some other key highlights of the CMS proposal: The […]