Tag: Medicare Physician Fee Schedule

Historical Medical code set

Mastering Historical Medical Code Sets for Audits, Appeals, and Research

Remaining up-to-date is essential in the healthcare industry, but relying solely on current codes isn’t always the best approach. When auditing, handling appeals, or researching code usage for past encounters, a solid grasp of the descriptors and guidelines applicable during the date of service (DOS) can profoundly impact outcomes. Here’s a concise guide on effectively […]
Medicare Physician Pay Cuts

CMS Finalizes MPFS with 2.9% Medicare Physician Pay Cuts

The Centers for Medicare & Medicaid Services (CMS) has finalized its 2025 Medicare Physician Fee Schedule, which includes a 2.9% Medicare Physician Pay Cuts to physician payments. This decision, despite opposition from major industry groups, will impact healthcare providers and potentially patient access to care. The rule also includes several positive provisions, such as expanded […]
impact urology practices

Medicare Physician Fee Schedule 2025: Urology Practice Impact

urology practices: The Centers for Medicare & Medicaid Services (CMS) unveiled its proposed Medicare Physician Fee Schedule for 2025 on July 10, 2024. This outlines potential payment adjustments and policy changes that would take effect starting January 1, 2025. A public comment period will follow, during which CMS will gather feedback to inform the final […]
Medicare payment cut

Medicare Payment Cuts Hit Physicians: 2.93% Reduction in 2025

Medicare payment cut: The Centers for Medicare & Medicaid Services (CMS) has released its proposed rule for the 2025 Medicare Physician Fee Schedule (MPFS), which includes a 2.93% average payment rate reduction for physicians. This comes despite the agency’s stated commitment to advancing health equity and supporting whole-person care through initiatives like strengthening primary care […]
Medicare Conversion Factor

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) […]
MPFS final rule

Key Changes In CY 2024 MPFS Final Rule: New E/M Code, Telehealth Updates, And More

The CY 24 MPFS final rule last run the show was disseminated inside the November 16, 2023 Government Select. The run they appear addresses updated installment for specialist and other specialist administrations conjointly sets out unused rulemaking concerning certain other providers and things, such as ambulances, inquiries about offices and other demonstrative offices, and pharmaceutical […]
Value-Based-Care-Plans-improved-health-outcomes-for-MA-members

Medicare Advantage Value-Based Care: Enhanced Health Outcomes

Alongside its positive impact on health outcomes, the Medicare Advantage value-based care plans implemented by an insurance provider resulted in a significant $8 billion in cost savings throughout 2022. Reports from the payer revealed that Medicare Advantage beneficiaries under value-based care exhibited improved health conditions, marked by reduced inpatient admissions and emergency room visits. The […]
Physicians-face-potential-Medicare-reimbursement-cuts-in-2024

Anticipated Decrease in Medicare Reimbursement for Physicians in 2024

The Final Decrease Is Influenced By Add-On Codes and Regulatory Obligations On November 16th, the Centers for Medicare & Medicaid Services (CMS) released the finalized rule for the 2024 Medicare Physician Fee Schedule (MPFS) in the Federal Register. While the policies exhibit several positives, especially in primary care, telehealth, and behavioral healthcare, CMS remains dedicated […]
2024-Medicare-OPPS-Rule

2024 Medicare Outpatient Prospective Payment System Proposed Rules

The OPPS proposal lacked any mention of several prominent issues that industry leaders have eagerly awaited reforms on. Yesterday, federal officials introduced two sets of proposed rules, which included possible revisions to the Medicare Physician Fee Schedule (PFS) and Outpatient Prospective Payment System (OPPS) for the 2024 calendar year. Within the PFS proposed rule alone, […]