By Lisa Eramo bio There is a whole slew of new and revised CPT codes—329 changes to be exact—effective since Jan. 1. This includes 206 new codes, 54 deletions, and 69 revisions. Interestingly, the majority of changes pertaining to new technology and devices, giving medical practices the opportunity to provide high-quality patient care while also receiving reimbursement. This … [Read more...] about New devices, technology dominate 2021 CPT code changes
Billing & collections
Two data deadlines approaching this month
Two deadlines are coming up for physician practices: The Quality Payment Program Doctors and Clinicians Preview Period will close on March 25. And the data submission period for Merit-based Incentive Payment System eligible clinicians who participated in the 2020 performance year of the Quality Payment Program (QPP) ends March 31. Preview your performance information CMS opened … [Read more...] about Two data deadlines approaching this month
The physician enterprise model: a non-employment alternative
By John W. McDaniel bio Hospitals are seeking new and innovative ways to affiliate with physicians that differ from tactics used in the 1990s, These new relationships involve a more formal type of relationship with physicians, which might reflect lessons learned through previous less‐than‐satisfactory relationships. Most hospitals have physician integration strategies as a … [Read more...] about The physician enterprise model: a non-employment alternative
Updated info for Pfizer-BioNTech vaccine
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
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