Tag: Medicare Payments

CMS Unveils Proposed Rules Impacting Medicare Payments for 2025

CMS Unveils Proposed Rules Impacting Medicare Payments for 2025

The Centers for Medicare & Medicaid Services (CMS) has unveiled a series of Medicare payment rules that will dramatically impact Medicare payments for 2025. These changes encompass payment rates, coding guidelines, coverage criteria, and quality measures for various healthcare providers. Physicians, in particular, face a proposed average payment rate cut of 2.93% under the fee […]
Medicare Conversion Factor Increases, But Payments Remain Lower

Medicare Conversion Factor Increases, But Payments Remain Lower

Medicare Conversion factor are up but payouts are still down compared to last year. Healthcare professionals will see a slight upward adjustment to their Medicare payments starting March 9 after President Biden signs the Consolidated Appropriations Act (CAA), 2024.  Really fortunately, although the 2024 CAA increases the conversion factor (CF) finalized for calendar year (CY) […]
Rural Health Clinic Policies Revised

Rural Health Clinic Policies Revised

  Don’t send another RHC claim until you’ve reviewed these key changes for 2022. A Rural Health Clinic (RHC) is a clinic located in a rural, underserved area with a shortage of primary care providers, personal health services, or both. Medicare pays RHCs for the provision of certain primary care and preventive health services in […]
CMS Releases 2022 Physician Fee Schedule Final Rule

CMS Releases 2022 Physician Fee Schedule Final Rule

The Centers for Medicare & Medicaid Services (CMS) has finalized 2022 payments and policies under the Medicare Physician Fee Schedule (MPFS). The rule includes updates to payment rates for physicians and other healthcare professionals for calendar year (CY) 2022; expands the use of telehealth for mental health; clarifies policies related to split (shared) visits, critical […]
CMS Releases Physician Fee Schedule Final Rule

CMS Releases Physician Fee Schedule Final Rule

  CMS says it the goal is to support health equity while focusing on high-quality person-centered care. Increased leverage of telehealth for behavioral care, diabetes prevention and mitigation, and enhanced payment for vaccine administration were three out of many priorities cited by federal officials who announced the release of the Centers for Medicare & Medicaid […]
Top Challenges of the Merit-Based Incentive Payment System

Top Challenges of the Merit-Based Incentive Payment System

  The Government Accountability Office (GAO) analyzed performance data from providers who participated in the Merit-Based Incentive Payment System (MIPS) between 2017 and 2019 and found that some providers experienced MIPS challenges. Under MIPS, CMS monitors provider performance in four different categories: quality, improvement activities, promoting interoperability, and cost. The providers receive scores in each […]
The Changing Landscape of Healthcare B2B Payment Transactions

The Changing Landscape of Healthcare B2B Payment Transactions

Healthcare B2B payment transactions have been high in 2021, potentially signaling the importance of electronic payment transfers as the nation emerges from the coronavirus pandemic, according to a report from National Automated Clearing House Association (NACHA). Nacha oversees the ACH Network, a national payment system. B2B payments made through this network in the healthcare industry […]