In Billing
May 23rd, 2019
Beginning July 2019, oncologists who are part of the Center for Medicare & Medicaid Services’ (CMS) voluntary Oncology Care Model (OCM) who haven’t achieved a performance-based payment (PBP) will be switched from a 1-sided risk model to a 2-sided risk model.   According to an Avalere study, half of those being switched will lose money. Avalere advises ...
In Billing
Dec 11th, 2018
Effective March 16, 2018, Medicare will cover diagnostic laboratory tests using next generation sequencing (NGS) when ordered by a treating physician and performed in a Clinical Laboratory Improvement Amendments (CLIA) certified lab. Other specific requirements also must be met. The Centers for Medicare & Medicaid Services (CMS) revised the national coverage determination for NGS (NCD ...
In Billing
Mar 22nd, 2018
Providers can now be reimbursed for Next Generation Sequencing (NGS) tests for specific cancer situations, a national coverage determination (NCD) by Medicare, the Centers for Medicare & Medicaid Services recently announced. For medical coders working with advanced cancer patients who may be able to be treated based on the genetic makeup of the cancer, this ...
In CMS
Oct 13th, 2016
On Oct. 13, the Centers for Medicare & Medicaid Services (CMS) announced its effort to relieve some of the administrative burdens of Advanced Alternative Payment Models (APMs) on physicians. While implementing new healthcare delivery system reforms stemmed from the Affordable Care Act and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), CMS wants clinicians ...
Get an overall understanding of hospital and freestanding center radiation oncology payments. By Cindy C. Parman, CPC, COC, RCC The quote, “Change always comes bearing gifts,” by Price Pritchett, PhD, accurately captures coders’ feelings when final regulations, code updates, and other reimbursement changes occur, each year. This year, radiation oncology has experienced some of the ...