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Highlight E/M, Opioid Use Treatment, PAs, and Single-Disease Care in 2020 MPFS Final Rule

11. November 2019

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Medicare has released the Medicare Physician Fee Schedule (MPFS) for 2020. Let’s see how it stacks up against some of the proposals from Medicare that we looked at back in August. Expect Separate Payment for E/M Office Levels in 2021 Even though we’re still in 2019, a lot of us have 2021 E/M coding changes […]

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What’s Proposed for MIPS in 2020 and What Are MVPs?

29. August 2019

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The Quality Payment Program (QPP) proposed rule for 2020 adds some insights into what we may see in 2021, as well. One possibility is a new MIPS Value Pathways (MVPs) framework. Here is a look at the highlights for these MACRA-related updates. Prepare for Performance Threshold Points to Go Up First up, the QPP 2020 […]

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Add These AUC-Related Modifiers to Your Imaging Claims in 2020

12. August 2019

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At the end of July, Medicare released a set of modifiers that you need to know if you’re involved in ordering or coding for imaging. The modifiers, effective Jan. 1, 2020, are part of Medicare’s changes related to Appropriate Use Criteria (AUC) for advanced diagnostic imaging services. Check out the AUC-related modifiers below and then […]

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MPFS 2020 Proposed Rule: E/M Blended Payment for 2021 Is Dead

5. August 2019

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Another day, another change to E/M plans for 2021! Medicare has released the 2020 proposed rule for the Medicare Physician Fee Schedule (MPFS), bringing in the recent AMA plan to revise E/M coding in 2021. But what does the MPFS say about Medicare payment for office/outpatient visits in 2021? Here’s the scoop. Know What to […]

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PDPM: Snap Up This ICD-10-CM Knowledge for Your SNF

17. June 2019

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The Patient Driven Payment Model is bringing new importance to the ICD-10-CM code set for SNFs. Here’s where the diagnosis codes will come into play. Get a Quick Overview of the PDPM The Patient Driven Payment Model (PDPM) is a new case-mix classification system that will replace the Resource Utilization Group, Version IV (RUG-IV), effective […]

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Update Your Knowledge of MIPS Promoting Interoperability for 2019

4. February 2019

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In 2019, there are some changes to the Promoting Interoperability performance category of MIPS. Here’s what you need to know about CEHRT and scoring news for this performance year. Background: MACRA requires the Quality Payment Program (QPP) to include a MIPS performance category on meaningful use of certified EHR technology, the QPP 2019 rule states. […]

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Primary Care and Specialists Need to Know These Twin Add-On Codes by 2021

28. January 2019

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The 2019 MPFS proposed rule discussed potential add-on G codes to represent E/M visit complexity. Here’s a quick look at the intent of the proposed codes and what the final rule had to say about their implementation in 2021. See What Happens to This Code for Specialists In the 2019 Medicare Physician Fee Schedule (MPFS) […]

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Say Cheese! Medicare Is Paying for Photo and Video Evals in 2019

17. January 2019

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If a picture is worth 1,000 words, how much is evaluating a picture worth? Medicare has taken a stance on that. As of Jan. 1, 2019, Medicare is paying for remote evaluation of pre-recorded patient videos and images reported using G2010. Here’s what we know from the Medicare Physician Fee Schedule Final Rule. Compare Our […]

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Get the Latest on Changes to Medicare’s 2019 History Documentation Requirements

20. December 2018

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We’ve been talking a lot about the 2019 Medicare Physician Fee Schedule final rule, but when there are changes to E/M rules, there can never be enough information, right? CMS recently released a response to a question that arose during a provider call about what parts of history ancillary staff or the beneficiary can document […]

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Pop Quiz: Test Your Assumptions About QPP 2019 Payment Year

10. December 2018

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Understanding the Medicare Quality Payment Program (QPP) is tough. But the data Medicare released from the 2017 performance year shows you were up for the challenge. And that’s good news because the 2017 performance year affects 2019 Medicare payments and maybe has helped you prepare for the 2019 performance year, too. Let’s see how you […]

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