Ready for some retroactive MPFS changes? The next Medicare Physician Fee Schedule update may have an April 1, 2019, implementation date, but the effective date is Jan. 1, 2019. The theme for the HCPCS codes involved is Next Generation Accountable Care Organization (NGACO) Model Post Discharge Home Visits. Remember: “MACs will not search their files […]
Continue reading...12. March 2019
OIG audit targets can feel like moving targets with the website updated each month. Find out where you can go to keep tabs on the Office of Inspector General’s Work Plan items, and see an example of a recently added area to watch. (Tip: For more OIG information, you also can check out this free […]
Continue reading...4. February 2019
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. […]
Continue reading...24. January 2019
The 2018 CERT report estimates 58 percent of Medicare improper payments were caused by insufficient documentation (and this is an ongoing trend). More than half is nothing to sneeze at, especially when you consider that those documentation problems could lead to having to repay Medicare or having to spend time working on underpayments. Here’s a […]
Continue reading...17. January 2019
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 […]
Continue reading...14. January 2019
In the 2019 Medicare Physician Fee Schedule (MPFS), the conversion factor is 36.0391 compared to 35.9996 in 2018. But that sort of information helps only if you know what a conversion factor is and what to do with it. Here’s a primer you can turn to when you need to brush up on your MPFS […]
Continue reading...10. January 2019
We’re in the third year of the Quality Payment Program (QPP), which includes the Merit-based Incentive Payment System (MIPS). The QPP is connected to the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Because MIPS may result in Medicare payment adjustments up or down, knowing whether you’re required to participate is an essential first […]
Continue reading...7. January 2019
Exploiting modifier 59 was a major factor in a recent $12.5 million settlement for False Claims Act allegations. How’s that for motivation to shore up your modifier 59 know-how? Here are some resources to get you on your way. Read the Write-Up on the Recent False Claims Act Settlement Find out some of the details […]
Continue reading...20. December 2018
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 […]
Continue reading...10. December 2018
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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18. March 2019
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