On Dec. 11, 2020, the U.S. Food and Drug Administration issued an Emergency Use Authorization (EUA) for the Pfizer-BioNTech COVID‑19 Vaccine for the prevention of COVID-19 for individuals 16 years of age and older. Review Pfizer’s Fact Sheet for Healthcare Providers Administering Vaccine (Vaccination Providers) regarding the limitations of authorized use. During the COVID-19 … [Read more...] about Updated info for Pfizer-BioNTech vaccine
Billing & collections
Impact of reimbursement and compliance to WRVU-based compensation
By John McDaniel bio All physician contracts including any form of WRVU based compensation may need to be reviewed and probably amended because of the increase in WRVUʹs (work relative value units) associated with E&M CPT codes effective Jan. 1, 2021. This has been necessitated by CMS whereby the final decision involved eliminating CPT Code 99201 and leaving CPT Code … [Read more...] about Impact of reimbursement and compliance to WRVU-based compensation
The new paradigm for physician compensation: payment for value/quality v. volume
By John McDaniel bio How will physician compensation arrangements be impacted by quality incentive payments with respect to determining Fair Market Value and commercial reasonability? The enactment of the Medicare Access and CHIP Reauthorization Act (MACRA) in November 2016 set forth future options for payment from Medicare, those being participation in the Merit‐Based … [Read more...] about The new paradigm for physician compensation: payment for value/quality v. volume
New deadline of Dec. 13 to update APM Incentive billing info
Is your office among the clinicians that need to verify Medicare billing information by Dec. 13 in order to receive payments? The Centers for Medicare & Medicaid Services (CMS) Quality Payment Program website includes 2020 Alternative Payment Model (APM) Incentive Payment details. To access information on the incentive amount and organization paid, clinicians and surrogates … [Read more...] about New deadline of Dec. 13 to update APM Incentive billing info
Impact of 2021 evaluation and management coding changes to WRVU based physician compensation
By John McDaniel bio As you may know, all physician contracts which include any form of WRVU based compensation will need to be reviewed and probably amended due to the increase in WRVUs (work relative value units) associated with E&M CPT codes effective Jan. 1, 2021. We recently conducted an assessment for one of our hospital clients which showed the ʺunintended … [Read more...] about Impact of 2021 evaluation and management coding changes to WRVU based physician compensation
Retaining patients as insurance landscape shifts
By Kerri Lenderman bio Walmart’s July announcement that they plan to start selling Medicare insurance should have resonated with America’s physicians as more than an interesting headline to interrupt a summer of coronavirus news. Indeed, it should be a wakeup call and a reminder that unsettling and unconventional forces with deep pockets and consumer brand loyalty are forming … [Read more...] about Retaining patients as insurance landscape shifts
Deadline Oct. 5 to ask for MIPS targeted review
If you participated in the Merit-based Incentive Payment System (MIPS) in 2019, your performance feedback, including your MIPS final score and payment adjustment factor(s), is now available for review on the Quality Payment Program website. This final score determines the payment adjustment you will receive in 2021, with a positive, negative, or neutral payment adjustment … [Read more...] about Deadline Oct. 5 to ask for MIPS targeted review
Your office will be paid for counselling patients to self-isolate at time of COVID-19 testing
CMS and the Centers for Disease Control and Prevention (CDC) have announced that payment is available to physicians and health care providers to counsel patients at the time of COVID-19 testing about the importance of self-isolation after they are tested and prior to the onset of symptoms. The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic, and … [Read more...] about Your office will be paid for counselling patients to self-isolate at time of COVID-19 testing
Protecting your medical practice during uncertain times
By John W. McDaniel bio Given the recent disruption and decreased demand for physician office services, coupled with the foreboding predictions associated with the COVID-19 pandemic, both hospital- affiliated and private medical practices are having to adjust their operations in order to provide billable patient care services while salvaging the cash flow/liquidity of the … [Read more...] about Protecting your medical practice during uncertain times
CMS to launch new MIPS Participation Framework in 2021 Performance Period
CMS is implementing a new participation framework for the Merit-based Incentive Payment System (MIPS), called the MIPS Value Pathways (MVPs), starting with the 2021 performance period. The goal of this new framework is to move away from siloed performance category measures and activities, and move toward an aligned set of measures and activities that are more meaningful to … [Read more...] about CMS to launch new MIPS Participation Framework in 2021 Performance Period