Tag Archive | "MPFS"

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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Do You Land in the Winner Column for MPFS 2019?

Thursday, December 6, 2018

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For the 2019 Medicare Physician Fee Schedule (MPFS), we’ve talked about E/M and a bit about remote monitoring. But now let’s take a general overview of the ups and downs expected for individual specialties. Know Where to Find the Info and What It Means Table 94 of the 2019 MPFS final rule is titled “CY […]

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2019 MPFS: Prolonged Preventive Service Codes May Make It On to Telehealth List

Tuesday, September 25, 2018

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If telehealth is on your radar, you’ll want to watch the Medicare Physician Fee Schedule for 2019. The MPFS 2019 proposed rule discusses potential changes to Medicare telehealth services, specifically the addition of G0513 and G0514 to the Medicare telehealth list. Get a closer look at these codes so you’ll better understand them and the […]

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Hot Topic: Get the Scoop on Proposed MPFS 2019 Changes to E/M Coding and Payment

Friday, August 3, 2018

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The 2019 proposed Medicare Physician Fee Schedule (MPFS) includes some major potential changes to E/M coding and payment in its 665 pages. Major. Here are the highlights. Just remember that what’s below is proposed and may change before the final rule is implemented. Here’s the Big Payment News About Levels 2-5 Let’s get right to […]

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Prep Time! July 2018 MPFS Updates Bring More Than RVU Changes

Friday, June 1, 2018

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We’re a month away from the July 2018 Medicare Physician Fee Schedule (MPFS) update. These quarterly changes are easy to overlook, but checking any fee schedule update is important. Even if, for some reason, you’re not interested in RVU changes, there may be changes to indicators (like PC/TC) that affect proper reporting. Here are some […]

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