The Medicare Payment Advisory Commission’s (MedPAC) June Report to the Congress addresses (among other things) issues it sees with the Merit-based Incentive Payment System (MIPS) — one of two paths in the Centers for Medicare & Medicaid Services’ (CMS) Quality Payment Program, and a provision of the Medicare Access and CHIP Reauthorization Act (MACRA). “As ...
In CMS
Mar 13th, 2017
House plans to replace Obamacare through a proposed Congressional reconciliation bill would reduce federal deficits by $323 billion of on-budget savings and $13 billion in off-budget by 2026, but the human cost will be high, according to the Congressional Budget Office (CBO). The bipartisan agency said 14 more people would be uninsured in 2018 under ...
Sep 1st, 2013
Part 1: Use effective communication to coach providers towards better record keeping. Brenda Chidester-Palmer, CPC, CPC-I, CCS-P Editor’s Note: This is the first part of a two-part series. In the next article, we’ll discuss how best to relay your audit results to the overseeing physician, committee, or board. One of the most important aspects of ...
Jul 1st, 2013
CMS says to use E/M codes to report these services, but you’ll have to play by their rules to get paid. By G.J. Verhovshek, MA, CPC, Medicare stopped accepting claims for outpatient (99241-99245) and inpatient (99251-99255) consultations as of Jan. 1, 2010, but physicians haven’t stopped providing these services. How are they getting paid? After ...
Jun 1st, 2013
Proper documentation is a must for reimbursement of 99241–99245, 99251–99255. By G.J. Verhovshek, MA, CPC Medicare payers haven’t accepted claims for either outpatient (99241-99245) or inpatient (99251-99255) consultations since Jan. 1, 2010. Private payers, however, may still pay for consultation services as long as those services are supported by the “three Rs” of consult documentation: ...