The Centers for Medicare & Medicaid Services (CMS) recently announced plans to continue allowing certain telehealth flexibilities beyond the end of 2024. These changes are part of their proposed rules for Medicare payments in 2025. While most temporary telehealth rules from the COVID-19 pandemic are set to expire, CMS wants to keep some in place. […]
Understanding Modifier 95: A Brief Overview Modifier 95 is a medical billing code used to indicate that a service was provided via telehealth. This modifier is essential for ensuring that healthcare providers receive appropriate reimbursement for remote services. Here are the key points about Modifier 95: Purpose: Modifier 95 is appended to the CPT or […]
The Centers for Medicare & Medicaid Services (CMS) has unveiled a series of Medicare payment rules that will dramatically impact Medicare payments for 2025. These changes encompass payment rates, coding guidelines, coverage criteria, and quality measures for various healthcare providers. Physicians, in particular, face a proposed average payment rate cut of 2.93% under the fee […]
On July 10, 2024, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after January 1, 2025. The calendar year (CY) 2025 PFS proposed […]
Telehealth billing, the process of submitting claims for telehealth services, is an essential component of this virtual care model. Efficient and accurate telehealth billing ensures that providers are reimbursed for their services and that patients are not overbilled. The healthcare landscape has undeniably shifted towards a more virtual model. Telehealth, the utilization of telecommunications technology […]
In the wake of the COVID-19 pandemic, independent medical practices face many challenges, from adapting to new healthcare methods to major regulatory changes. The main focus of this study is to increase Medicare spending. With the right strategies, independent medical practices can achieve financial sustainability while continuing to provide quality care to their patients. This […]
Medical coding practices’ evolve as the healthcare landscape rapidly transforms with telemedicine leading the way and the proliferation of virtual consultations. In addition to the unique challenges and opportunities presented by these changes, it is also important to remember that optimizing medical coding procedures and ensuring appropriate reimbursements are also unique challenges presented by these […]
The 2024 Medicare Physician Fee Schedule, recently released by CMS, confirms the anticipated reduction in payments for physicians. The finalized conversion factor of $32.7442 represents a 3.4% decrease from the 2023 rates, which themselves saw a 2% reduction from 2022. In contrast, the Medicare Economic Index, a gauge of practice cost inflation, surged to 4.6%, […]
Telehealth has gained widespread acceptance among numerous medical practices and hospitals owing to its convenience, accessibility, and effectiveness in curbing the spread of infectious diseases. However, it’s important to recognize that telehealth is not exclusive to large institutions; small practices can also reap its benefits. Telehealth, also known as telemedicine, revolves around utilizing technology to […]
On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released a proposed rule seeking public feedback on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues. These changes are set to take effect on or after January 1, 2024. The proposed rule for […]