Tag: physician reimbursement

Medicare Physician Reimbursement Cuts

Medicare Physician Reimbursement Cuts: Doctors Warn of Healthcare Crisis

Physicians have expressed strong opposition to the newly proposed federal spending plan, which fails to address a crucial issue: the 2.83% reduction in Medicare Physician Fee Schedule reimbursement for 2025, representing significant Medicare Physician Reimbursement Cuts. While the House of Representatives Appropriations Committee introduced the bill on March 8, with an anticipated floor vote this […]
Medicare reimbursement cuts

Medicare reimbursement cuts and their impact on private practice physicians

Medicare is failing both patients and physicians. After adjusting for inflation, physician reimbursement under Medicare has declined by 33% from 2001 to 2025, according to the American Medical Association. In stark contrast, Medicare payments to hospitals have surged by nearly 60%, while hospital executive salaries have skyrocketed 93% over the past decade. How can private […]
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) […]
New Billing Codes-for Prior Authorization Work Proposed by AMA

AMA Aims to Streamline Prior Authorization Billing with New Codes

New billing codes: Medical experts might consider creating new billing codes for the time doctors and their support staff spends working on prior authorizations. The American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Board meets May 9-11 in Chicago. On the meeting’s agenda are three potential new CPT codes “for reporting services (physician, QHP, […]
2024 Medicare physician fee schedule

Medicare CY 2024 Proposed Rule: Impact, Reimbursement Changes, and Key Insights

On July 13, Medicare released its Proposed Rule, which outlined changes to different Medicare programmes including as quality programmes, MIPS, rural employment, telemedicine, and others. This comprehensive yearly document of 2,033 pages covers the planned programme adjustments for fiscal year 2024. Between the release of the Draft Rule and the publishing of the Final Rule […]
CMS-Final-Rule's-Reduction-on-physician-reimbursement

CMS Final Rule 2023: Impact on Physician Reimbursement and Healthcare Facilities

Despite the American Medical Association’s (AMA) strong protests regarding a 26 percent decrease in physician reimbursement from 2001 to 2023, it seems that these objections have not been heeded. On November 2, the Centers for Medicare & Medicaid Services (CMS) announced their final policy changes, which include significant reductions in reimbursement for the upcoming year. […]
3-Policies-Controlling-Physician-Reimbursements

The 3 Policies Controlling Physician Reimbursements

Three big CMS moves have affected physician reimbursements in the last 10 years, according to VMG Health’s 2023 mergers and acquisitions report released on March 21: Here are the three CMS policies: In April 2015, the Senate passed the Medicare Access and CHIP Reauthorization Act, which permanently removed the sustainable growth rate formula under the […]
EM-Payment-Policy-Changes-Impact-Physician-Reimbursement

E/M Payment Policy Changes Impact Physician Reimbursement

Following E/M payment policy changes, the reimbursement gap between primary care and specialty physicians decreased by just $825, falling from $40,259.80 to $39,434.70. Evaluation and management (E/M) payment policy changes implemented in 2021 resulted in higher Medicare reimbursement for most physicians but only led to a modest decrease in the payment gap between primary care […]
Latest-Guidelines-for-Coding-EM-services-in-2023

Latest Guidelines for Medical Coding E/M services in 2023

A thorough understanding of the latest guidelines for coding evaluation and management services is necessary to ensure compliant claims. You’ve likely heard about the 2023 CPT® changes for reporting hospital inpatient and observation evaluation and management (E/M) services. AAPC has been preparing medical coders for these changes since they were announced and started offering education […]