Tag Archive | "MPFS"

What Does the 2020 MPFS Say About Nasal/Sinus Endoscopy Payment?

Monday, December 16, 2019

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The 2020 Medicare Physician Fee Schedule (MPFS) final rule states Medicare will apply the special rule for multiple endoscopic procedures to nasal/sinus endoscopy medical codes 31231-31298. In case you don’t have time to wade through the whole long rule, here are the major pointers on this change for otolaryngology coders. The change will be effective […]

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

Monday, November 11, 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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Get the Scoop on Proposed Medicare Codes for Managing 1 Chronic Condition

Thursday, October 10, 2019

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You’ve got Chronic Care Management (CCM) codes when a patient has multiple chronic conditions to manage, but what about when there’s just one? To help solve the problem, Medicare wants to introduce new codes for Principal Care Management (PCM). Here’s more on that from the 2020 Medicare Physician Fee Schedule (MPFS) proposed rule. Start With […]

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Get Pro/Tech Component Refresher From October MPFS Update

Monday, September 23, 2019

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When you think of professional component and technical component, Medicare’s division of a single code may spring to mind. But the October 2019 update to the Medicare Physician Fee Schedule (MPFS) has a dermatology example that shows there’s more than one way to think about PC/TC. Here are the details. RVUs for PC + TC […]

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

Monday, August 5, 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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Modifier 51 Hints: Your Go-To Guide for the MPFS Multiple Procedure Column

Thursday, June 13, 2019

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There are nine different Multiple Procedure indicators on the Medicare Physician Fee Schedule (MPFS), meaning there are a lot of payment adjustment possibilities you need to know. Here’s each indicator, an example of a code with that indicator, and a quick look at where modifier 51 comes into play. What Is Modifier 51? The basic […]

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Watch April MPFS Update for NGACO Code Changes With a January Twist

Monday, March 18, 2019

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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 […]

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Bring in Correct Bilateral Procedure Pay With These Pro Pointers

Thursday, February 7, 2019

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Choosing medical codes and modifiers for bilateral services can be confusing. Here are a few questions you can ask to help ensure accurate coding and reimbursement for physician claims. Does the Code Descriptor Specify Bilateral? “Bilateral surgeries are procedures performed on both sides of the body during the same operative session or on the same […]

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

Thursday, January 17, 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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Take the Mystery Out of the MPFS Conversion Factor and Calculations

Monday, January 14, 2019

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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 […]

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