Tag: HCPCS Codes

2021 MPFS Payment Rates

CMS Recalculates Medicare Physician Fee Schedule Rates for 2021

  CMS has updated Medicare Physician Fee Schedule rates for 2021 after a COVID-19 stimulus package mitigated budget neutrality cuts finalized in a December rule. The Consolidated Appropriations Act, 2021 passed by Congress on Dec. 21, 2020, enacted a 3.75 percent increase in Physician Fee Schedule payments for all providers in 2021 to “support physicians and other professionals in adjusting […]
Learn More
2021 Evaluation & Management Code Changes

A Glance at 2021 Evaluation and Management Changes

The evaluation and management (E/M) changes for calendar year 2021 are the result of a collaborative effort between the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS). CMS first addressed the changes in the 2020 Medicare Physician Fee Schedule Final Rule, in which CMS indicated that it planned on adopting […]
Learn More
Medicare Reimbursement rate for COVID-19 Testing

CMS Reduces Medicare Reimbursement Rate for Some COVID-19 Tests

The base Medicare reimbursement rate for COVID-19 tests using high throughput technology will decrease to $75 next year unless labs can process results in 2 days or less. CMS will reduce the base Medicare reimbursement rate for COVID-19 tests done by laboratories using high throughput technology, according to a new announcement. The announcement made late last […]
Learn More
2021 Telehealth Reimbursement

CMS Outlines Telehealth Reimbursement for 2020-21 eCQM Programs

  The documents released earlier this month offer details on 42 eCQMs for telehealth services during the 2020 performance period and 39 eCQMs for telehealth services during the 2021 performance period. The Centers for Medicare & Medicaid Services has released additional details on telehealth reimbursement through quality reporting programs for the 2020 and 2021 performance […]
Learn More
COVID-19 Coding

CMS Releases Medicare Payment Rates for COVID-19 Test CPT Codes

Medicare payment rates for CPT codes 87635, 86769, and 86328 range from $42.13 to $51.31, CMS recently announced. CMS recently revealed how much it will pay for new Current Procedural Terminology (CPT) codes developed by the American Medical Association (AMA) for COVID-19 diagnostic tests. The guidance previously detailed Medicare payment rates for Healthcare Common Procedure […]
Learn More
CPT code 99201

Understanding Why 99201 Will be Deleted

An overview of the proposed Medicare Physician Fee Schedule: The proposed Medicare Physician Fee Schedule (MPFS) rule for 2020 was officially released on Aug. 14, 2019, encompassing various elements. Among these are proposals such as adjusting the PFS conversion factor to $36.09, introducing new HCPCS codes for bundled episode-of-care treatment for opioid use disorders, revising […]
Learn More
Surgical Procedure

Procedural Codes: Global Surgery & Related Services

Multiple Surgeries Multiple surgeries are separate procedures performed by a physician on the same patient at the same operative session or on the same day. Multiple surgeries are distinguished from procedures that are components of or incidental to a primary procedure. Intraoperative services, incidental surgeries or components of surgeries will not be separately reimbursed. Reimbursement […]
Learn More
x