Tag: MIPS

Therapy Services Codes

Therapy Services Codes: A Complete Guide to CPT & HCPCS Codes

Therapy services play a vital role in healthcare, helping patients recover from injuries, manage chronic conditions, and improve overall well-being. To ensure accurate billing and reimbursement, healthcare providers must use the correct therapy services codes. These codes, primarily based on the Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS), help standardize claims […]
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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 […]
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Medicare Payment Cuts Hit Physicians: 2.93% Reduction in 2025

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 […]
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Clinicians Serving Socially At-Risk at a Disadvantage 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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2021 E_M Guideline and Leveling Changes

2021 E/M Guideline and Leveling Changes

Providers need a mechanism to be accurately reimbursed for the time and effort that they expend in providing care. Evaluation and Management (E/M) leveling has been the standard method in which to provide appropriate, defensible payments for services. However, it has been successfully argued that the 1995 and 1997 E/M guidelines in place today are […]
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Regulations on SNF Waivers and Telehealth

COVID-19 Impacts Regulations on SNF Waivers and Telehealth

As with last week, RACmonitor asked Dr. Ronald Hirsch, vice president of R1 RCM, to summarize the most pertinent regulatory changes recently arising. The following is a transcript of his reporting today on Monitor Mondays. “First, thank you, everyone, for continuing to care for patients and continuing to take this pandemic seriously,” Dr. Ronald Hirsch […]
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Medicare Reimbursement Rates for Kidney Care-1

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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