Tag: Medicare Reimbursement

2021 Medicare Physician Fee Schedule Rule

Top 3 Concerns with the 2021 Medicare Physician Fee Schedule Rule

Comments on the 2021 Medicare Physician Fee Schedule proposed rule centered on potential payment cuts, telehealth reimbursement, and quality reporting changes. Provider groups are concerned that some proposals in the Medicare Physician Fee Schedule rule for 2021 would exacerbate the financial challenges physicians are already facing during the COVID-19 pandemic, including lack of adequate telehealth […]
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Clinicians Disadvantages under MIPS

Clinicians Serving Socially At-Risk at a Disadvantage Under MIPS

  Clinicians who served more patients with social risk factors such as low income performed worse in the Merit-Based Incentive Payment System’s inaugural payment year, and therefore, received unfavorable value-based reimbursement, according to a new study. The study recently published in Health Affairs found that out of 510,020 clinicians participating in the Merit-Based Incentive Payment System (MIPS) in […]
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Telehealth Reimbursement

Telehealth Reimbursement Just for Value-Based Providers Post-COVID?

Telehealth reimbursement expansions granted during the PHE may be limited to providers in Advanced APMs moving forward to prevent program integrity issues, MedPAC said at a recent meeting. The Medicare Payment Advisory Commission (MedPAC) is the latest group to weigh telehealth reimbursement expansions after the COVID-19 pandemic. In a meeting held virtually last week, MedPAC analysts Ariel […]
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Medicare Billing Updates

CMS Updates Medicare Billing Rules for 20% Add-On COVID-19 Payment

  In addition to Medicare billing updates, the federal agency also announced that it will resume routine inspections for all Medicare and Medicaid-certified providers. Claims eligible for the 20 percent add-on payment for COVID-19 hospitalizations will now have to have a positive laboratory test documented in the patient’s medical record, according to recent Medicare billing […]
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COVID-19 billing updates

CMS Pays for Coronavirus Counseling, Other COVID-19 Billing Updates

Provider reimbursement is now available to physicians who tell their patients to self-isolate at the time of COVID-19 testing, according to CMS. An announcement released late last week in collaboration with the Centers for Disease Control and Prevention (CDC) said CMS will leverage existing evaluation and management (E/M) payment codes to reimburse eligible providers for the coronavirus […]
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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 […]
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Telehealth Reimbursement

Providers Want Equal Telehealth Reimbursement Beyond COVID-19

With telehealth reimbursement flexibilities set to expire following the public health emergency period, providers are calling on HHS and policymakers to continue payment parity beyond COVID-19. Telehealth use has increased dramatically in a matter of weeks, enabling providers to continue seeing patients despite social distancing and shelter-at-home restrictions due to COVID-19. But these advancements could […]
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Telehealth Services

New Bill Would Codify Medicare Reimbursement for Telehealth Services

The bipartisan HEALTH Act would make permanent Medicare payments for telehealth services at federally qualified health centers and rural health clinics. U.S. Reps. G.K. Butterfield, D-North Carolina, and Glenn Thompson, R-Pa., introduced new legislation this week that would provide for permanent Medicare payments for telehealth services at federally qualified health centers and rural health clinics. The Helping […]
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Medicare-reimbursement

CMS Finalizes 2020 Medicare Reimbursement Rates for Kidney Care

The final rule for the CY 2020 End-Stage Renal Disease (ESRD) Prospective Payment System will boost Medicare reimbursement to encourage dialysis innovation. CMS last Thursday finalized a rule that will bump the bundled Medicare reimbursement rate for end-stage renal disease (ESRD) providers by $4.06 in 2020 and create a transitional add-on payment adjustment for certain new dialysis […]
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Medical Coding Services

CMS To Revamp Coding For New Medical Technology

Dive Brief CMS Administrator Seema Verma announced Thursday the agency will overhaul coding regulations that she argues have hindered beneficiary access to new medical technology. Medical device companies will now be able to apply for a new permanent Healthcare Common Procedure Coding System (HCPCS) code twice a year, instead of annually. CMS also recently eliminated […]
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