Tag: Reimbursement

Patient Counseling

CMS Announces New Payment Allocation for COVID-19 Patient Counseling

  CMS will leverage existing evaluation and management (E&M) payment codes to reimburse eligible providers for the coronavirus counseling services.  The Centers for Medicare & Medicaid Services (CMS) will make payment available to physicians and providers for counseling patients at the time of COVID-19 testing about the importance of self-isolation after they are tested and prior to […]
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Remote Patient Monitoring Update: Developments and Opportunities for Physicians

Remote Patient Monitoring Update: Developments and Opportunities for Physicians

Heading into 2020, adoption of telehealth services was already on the rise. Then the health crisis hit. Now it appears that COVID-19 has not only cemented telehealth’s place in the healthcare landscape but done so in a very big way. McKinsey & Co. is projecting that virtual visits could potentially account for $250 billion, or 20%, of […]
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Value based reimbursement

Coronavirus May Reshape Investment, Value-Based Reimbursement

The coronavirus pandemic will reshape where and how organizations invest moving forward, according to industry leaders at the Value-Based Care Summit | Telehealth20: Virtual Series. The coronavirus created an unprecedented rise in telehealth across the industry. Projects that would take years to implement were switched on in a matter of days in order to fit the growing […]
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Opportunity for Health Systems

4 Financial Opportunities for Health Systems Amid COVID-19

  Though healthcare organizations have endured a global health crisis that has severely taxed their bottom lines, there are areas for growth coming out of the pandemic. The outbreak of coronavirus disease 2019 (COVID-19) caused one of the most financially crippling situations for healthcare in decades. Besides the clinical implications, hospitals and health systems that […]
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COVID-19 Specimen Collection

COVID-19 Specimen Collection and Testing

How to code Medicare Part B claims for reimbursement. These past few months have been a whirlwind for everyone, but it’s fair to say medical coders have been hit with a category 5 hurricane. New codes and revised guidelines have been whirring about, making our heads spin. And now we have another new CPT® code […]
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BIlling for COVID-19 Care

Billing for COVID-19 Care

  In unprecedented crisis of COVID-19, the first instinct is to triage our activities, often weeding out the ones that seem to be the least important. Some of those will never surface again and just become part of the detritus left behind. Tucked into the recent CARES Act, the Coronavirus Preparedness and Response Supplemental Appropriations […]
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Serology Lab Testing Codes

News Alert: Two New CPT Codes Effective Immediately

Reimbursement details have not yet been established. The American Medical Association (AMA) CPT® Editorial Panel has made adjustments to one code and introduced two new codes to enhance the specificity of serology laboratory testing. These codes, released on April 10, are immediately applicable. Reimbursement arrangements for the Centers for Medicare & Medicaid Services (CMS) are […]
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Billing Codes for Coronavirus lab tests

CMS Develops New Billing Codes for Coronavirus Lab Tests

Two HCPCS billing codes will allow clinical laboratories and other providers to bill for certain coronavirus lab tests and support testing and tracking of new cases. CMS recently announced the development of new billing codes for coronavirus lab tests that will enable clinical laboratories and other providers to receive reimbursement for supporting patients during the outbreak and […]
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AI Can Help Health Plans

How AI Can Help Health Plans Become Member-Centric

Improving the customer experience is no longer an idea that’s relegated to the retail or hospitality industries. Now, the idea has gained traction across many industries, including healthcare. For health plans, improving the customer experience and providing member-centric care helps drive member acquisition and retention and improve reimbursement (via a better STARS rating). With so […]
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J Codes simplify Reimbursement

J Code Activations Simplify Billing Reimbursements For Practices

Several CMS-designated permanent and product-specific J-codes recently went into effect, allowing three ophthalmology-minded pharmaceutical companies to expand reimbursement through commercial and Medicare insurance plans. J-codes were activated Oct. 1 for FDA-approved products manufactured by EyePoint Pharmaceuticals, Ocular Therapeutix and Omeros. In the past, J-codes were announced once a year; now, CMS is issuing certain J-codes […]
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