In Billing
May 23rd, 2018
Here’s a summary of the changes for the July update to the 2018 Medicare Physician Fee Schedule Database (MPFSDB). Changes are effective for dates of service on and after July 1, 2018. Indicator Change for RHC and FQHC Care Management Codes For the following two HCPCS Level II codes, the PC/TC indicator is changed to 0 (zero) ...
Ten plus years and counting, and accuracy in evaluation and management (E/M) coding can still be troublesome and evasive. The initial guidelines in 1995 had some ambiguity in the examination component. This was clarified and strengthened in the 1997 guidelines, but the complexity of the bullet point-counting system seemed perplexing to many physicians. We now ...
There’s more than one way to determine your physician’s payment. Medicare fee-for-service payments are calculated based on relative value units (RVUs) assigned to each covered CPT®/HCPCS Level II code. As defined in Medicare’s National Physician Fee Schedule Relative Value File, there are three RVU categories that, when totaled, determine payment. Work RVUs account for the ...
By Edie Hamilton, CPC, CPC-I Reducing indicator, modifier, and calculation confusion will safeguard reimbursement. The Medicare Physician Fee Schedule (MPFS) was introduced in 1992 to replace the “reasonable and customary” payment methodology standard for physician services. Under the MPFS, payment has been based on relative value units (RVUs), which represent the value of work or ...
In Billing
Jan 19th, 2015
Confusion over  the 2015 Medicare Physician Fee Schedule (MPFS), which will be implemented April 1,  prompted the Centers for Medicare & Medicaid Services (CMS) to send out new files to payers, most of whom have implemented the data. Providers and payers are required to use the 2014 MPFS, until then. Payment files were issued to ...