Tag Archives: Medicare
News You Can Use: State Medicaid Programs Offer E/M, Vaccine Reimbursement Boosts
Posted on 08. May, 2013 by rpandit.
Watch for retroactive pay raises, if you self-attest.
Getting a payment increase from Medicaid sounds quite appealing to most practices, and it can be a reality for some primary care providers — but don’t forget to do your part to ensure that you’ll see a rise in Medicaid payments for E/M and vaccine services this year. Follow a few quick steps to confirm that you’ll get the raise.
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Practice Management: Time to Re-Enroll Your Gynecologist? You’ll Have an Easier Job, CMS Says
Posted on 24. Apr, 2013 by rpandit.
You can fax or email the revalidation documents this time around.
If your gynecologist sees Medicare patients, re-enrolling your provider every few years is on your to-do list. The good news is that CMS has made improvements to the re-enrollment process, according to an Oct. 10 CMS National Provider Call with the agency’s Provider Enrollment Operations Group.”
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News You Can Use: Stop Wondering: Congress Freezes Medicare Pay at 2012 Rates
Posted on 24. Apr, 2013 by rpandit.
However, don’t assume your HPSA bonus will continue.
As many practices are aware, medical offices nationwide were waiting to find out whether legislators halted a 26.5 percent pay cut that the 2013 Fee Schedule predicted, which would have brought the 2013 conversion factor down to $25.0008. In addition, practices were facing
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You’re Saved From 26.5 Percent Physician Pay Cut
Posted on 08. Apr, 2013 by rpandit.
But RVU changes still in effect.
Optometrists can expect a reprieve from the dreaded 2013 pay cut to the Medicare Physician Fee Schedule (PFS). Congress voted to halt the 26.5 percent rate cut that was tied to the sustainable growth rate (SGR) formula.
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Auditing: Is CMS Introducing Pre-Pay Audits in Your State?
Posted on 23. Oct, 2012 by rpandit.
Check whether your practice might come under extra scrutiny.
Here’s your latest heads up for auditing: Beginning August 27, 2012, CMS started its Recovery Audit Prepayment Review prepayment audits in 11 states. The information comes from an announcement on the CMS Web site.
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Reader Question: 401-405 or 272.x Can Help Justify 36415
Posted on 10. Oct, 2012 by rpandit.
Question: Some of our Medicare patients want to drop by and have blood drawn so that when they come for their next visit we’ll have the test results. We code 36415 to track the lab work, but the payers deny our claims. Does Medicare view this as part of either the prior visit, or the next when the doctor discusses lab results?
Florida Subscriber
Answer: No, Medicare should pay for the service if the patient hasn’t had a recent blood draw elsewhere for the same diagnosis. Continue to report 36415 (Collection of venous blood by venipuncture). Include a supporting diagnosis that relates to the lab test for which the blood is being drawn, such as hypertension (401-405, Hypertensive disease) or high cholesterol (such as 272.0, Disorders of lipoid metabolism; pure hypercholesterolemia). Include the patient’s usual physician as the referring doctor.
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Medicare Annual Exam Cuts Benefit, Requires Detailed Coding in RHCs
Posted on 05. Jan, 2011 by jennifer.godreau.
One element that physicians cheered in the new Medicare annual wellness exam has been eliminated and another that beneficiaries demanded will be delayed.
Bowing to Republican pressure, the White House agreed to cut the voluntary after care planning that was listed as an option in G0438 and G0439. In addition, Rural Health Clinics will need to
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Registration open for electronic health records incentives
Posted on 04. Jan, 2011 by dchandhok.
On Jan. 3, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) opened the registration for the Medicare and Medicaid electronic health record (EHR) incentive programs. It was started in Alaska, Iowa, Kentucky, Louisiana, Oklahoma, Michigan, Mississippi, North Carolina, South Carolina, Tennessee, and Texas and broad participation is invited from eligible professionals and eligible hospitals who wish to participate.
In February, the registration will open in
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CMS Releases 2011 Conversion Factor Rate
Posted on 28. Dec, 2010 by jennifer.godreau.
Despite adjusted rate of 33.9764, overall change is zero.
The President locked in a zero percent adjustment to your Medicare Part B payments but that doesn’t mean you’ve got the same rate.
The Medicare and Medicaid Extenders Act of 2010, which was signed into law on Dec. 15, established a payment update for 2011 of zero percent. To cover the cost of the provision, Medicare had to modify a physical therapy provision that was in the proposed 2011 Medicare Physician Fee Schedule final rule. “In addition, the final rule made other changes to the conversion factor, including a re-weighting of the work, practice expense and liability expense components of the relative value scale that resulted in a reduction in the numerical value of the conversion factor, even though
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Medicare Covers 99406, 99407
Posted on 13. Dec, 2010 by jennifer.godreau.
If you’ve been writing off tobacco cessation counseling as non-payable, it’s time to change your tune.
The change: In the past, you could collect for tobacco cessation counseling for a patient with a tobacco-related disease or with signs or symptoms of one. But on Aug. 25, CMS announced that “under new coverage, any smoker covered by Medicare will be able to receive tobacco cessation counseling from a qualified physician or other Medicare recognized practitioner who can work with them to help them stop using tobacco.”
“For too long, many tobacco users with Medicare coverage were denied access to evidencebased tobacco cessation counseling,” said Kathleen Sebelius, HHS secretary, in an Aug. 25 statement. “Most Medicare beneficiaries want to quit their tobacco use. Now, older adults and other Medicare beneficiaries can get the help they need to successfully overcome tobacco dependence.”
Count Attempts and Minutes
The new tobacco cessation counseling coverage expansion will apply to services under Medicare Part B and Part A. That means your physicians and coders should know how to correctly document and report the sessions.
“Medicare allows billing for two counseling attempts in a year, but each attempt can occur over multiple sessions, with
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