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Billing/Coding

ACR-Led Coalition on Underwater Biosimilars Grows, Charts Next Steps

From the College  |  August 5, 2024

New members include rheumatology state societies, specialty partners in gastroenterology and patient-facing organizations representing digestive and inflammatory diseases. The ACR and coalition partners are strategizing additional steps to ensure practices receive adequate reimbursement for biosimilars.

Methylprednisolone & Methotrexate: Codes & Billing Updated

From the College  |  April 22, 2024

As of April 1, HCPCS codes for methylprednisolone have changed. The ACR is working with the CMS to determine how rheumatologists should bill Medicare corrrectly.

CMS Updates the Medicare Conversion Factor

From the College  |  April 8, 2024

The Consolidated Appropriations Act, 2024 increased the Medicare conversion factor by 1.68% effective March 9, bringing it to $33.2875 for March 9–Dec. 31, 2024.

Congressional Action Partially Addresses Medicare Cuts

From the College  |  March 7, 2024

The newest funding package reduces the latest cut to Medicare reimbursement from 3.4% to 1.68%. Although rheumatologists are faring better under Medicare in 2024, broader reforms remain the ACR’s highest priority regarding Medicare payments to physicians.

Updated Coding Guidance for 2024 Remote Physiologic Monitoring & Therapeutic Monitoring

From the College  |  March 7, 2024

The Centers for Medicare & Medicaid Services updated recent regulations to clarify some points about remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services for key areas.

ACR Offers Lunch-and-Learn Series on Coding & Compliance for G2211

From the College  |  February 16, 2024

A free, tailored, one-hour series on coding and compliance for G2211 will help rheumatology practices bill correctly with the new add-on code to maximize reimbursements and minimize claim denials or rejections.

The ACR Advocates for G2211 Reimbursement under Medicare Advantage & Commercial Plans

From the College  |  February 3, 2024

The ACR is reaching out to Medicare Advantage and commercial payers to ensure appropriate reimbursement for the new complex care add-on code, G2211, implemented for outpatient office visits starting Jan. 1, 2024.

Updated G2211 Guidance Clarifies Use for Transient Problems

From the College  |  January 22, 2024

The complexity add-on code is appropriate to bill for an evaluation and management visit related to a transient or temporary problem when there is an established relationship for ongoing longitudinal care, even if the ongoing care is unrelated to the transient problem being treated.

Community Practice Rheumatology Is Challenging, But Rewarding, Too

Vanessa Caceres  |  January 10, 2024

Community practice rheumatology may be a less-followed path within the specialty, and it brings with it certain challenges. However, it also offers rewards, such as autonomy and deep relationships with patients. The Rheumatologist recently interviewed three community practice rheumatologists from around the U.S. to find out about their approaches to patient management, staffing and other…

2024 Remote Physiologic Monitoring and Therapeutic Monitoring Coding Guidance

From the College  |  January 9, 2024

This guidance from the ACR provides information about new remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) treatment management codes

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