Tag: medicare payment

Medicare rate for COVID-19 vaccinations

MA Reimburses 2X Medicare Rate for Some COVID-19 Vaccinations

Healthcare providers in Massachusetts are getting twice the standard Medicare rate for COVID-19 vaccinations in an effort to accelerate vaccine rollout, according to a recent provider bulletin from the state’s Medicaid office. The provider bulletin released in January 2020 states that providers administering the two-dose vaccines from Pfizer and Cambridge, Massachusetts-based Moderna will receive $33.88 for the […]
Learn More
NCTAP Coding and Billing

CMS Clarifies Coding and Billing for NCTAP

The NCTAP was finalized as part of CMS’ fourth COVID-19 interim final rule. CMS on January 27 updated coding and billing instructions to hospitals for new COVID-19 treatments add-on payment (NCTAP). The NCTAP was finalized as part of CMS’ fourth COVID-19 interim final rule with comment period (IFC-4) and is effective November 2, 2020 through the end of the public health […]
Learn More
2021 OPPS Final Rule

OPPS Final Rule Eliminates Inpatient Only List

The 2021 OPPS final rule seeks to increase patient choice and lower out-of-pocket costs. On Dec. 2, 2020, the Centers for Medicare & Medicaid Services (CMS) released the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System final rule for calendar year (CY) 2021. The final rule aims to provide Medicare recipients […]
Learn More
Surprise Billing Regulation

Congress Provides Relief on Medicare Payment; Passes Surprise Billing

  The $1.4 trillion omnibus legislative package passed by Congress late Monday includes COVID-19 related relief for physicians, imposes new restrictions on surprise billing, and funds the government through fiscal 2021, which ends Sept. 30. The legislation mitigates budget neutrality cuts that would have slashed physician Medicare payment rates by 10.2% and extends the moratorium on the […]
Learn More
2021 Medicare Payment Changes

Physician Groups Say Changes to Medicare Payment are Key for Primary Care

  The American College of Physicians (ACP) and other physician groups have written a letter to congressional leaders urging the implementation of essential changes to Medicare payments set to take effect Jan. 1. According to a news release, the Medicare Physician Fee Schedule for 2021 includes changes to Medicare payments for office visits and related evaluation […]
Learn More
Urology Coding

How Urology Coding Changed In 2020

As 2020 winds down, typically everyone from newscasters to sports reporters to anyone with a Twitter handle will write a “Year in Review” article, adding their predictions for the upcoming year. So we thought we would do the same – take a look back and also a look ahead. 2020 has been a fascinating year. […]
Learn More
Payment for New COVID-19 Treatments

CMS Finalizes Additional Payment for New COVID-19 Treatments

CMS’ Fourth COVID-19 Interim Final Rule with Comment Period (IFC-4) includes additional payment for new COVID-19 treatments, price transparency requirements for COVID-19 diagnostic tests, and coverage for potential vaccines among other provisions. Most provisions of IFC-4 became effective November 2. Hospital Payment for New COVID-19 Treatments The New COVID-19 Treatments Add-on Payment (NCTAP) will provide additional Medicare […]
Learn More
Medicare Reimbursement for Home Dialysis

CMS Expands Medicare Reimbursement for Home Dialysis, ESRD

New and innovative home dialysis machines will soon qualify for additional Medicare reimbursement, according to the latest End-Stage Renal Disease (ESRD) Prospective Payment System (PPS) final rule. CMS released the final rule yesterday, which introduced the new transitional add-on payment for dialysis machines used in patient homes and also included an update to Medicare reimbursement rates […]
Learn More
2020 Coding Guide

2020 Coding Guide: Get Paid What You’re Owed

  There’s nothing more frustrating than rendering a service and not being paid. Sometimes the problem comes down to a single code. Nuanced coding rules are difficult to understand, and physicians aren’t taught this information in medical school. Still, health care is a business. As business owners, physicians need to know how they’re paid, including […]
Learn More
x