Available topics include CPT telemedicine code sets, G2211 coding updates, evolving HIPAA guidelines, evaluation and management (E/M) coding and billing strategies.
Key Telemedicine Updates for 2025
As of Jan. 1, rheumatology practices face significant changes in coding and reimbursement for telemedicine services, including new and deleted billing codes, updated Medicare policies and looming expiration of pandemic-related flexibilities.
Billing and Coding Updates for G2211 in 2025
On Nov. 1, the Centers for Medicare & Medicaid Services finalized its proposal for an incremental expansion of the G2211 add-on code for complexity.
Unless Congress Acts, Medicare Reimbursement Will Remain Flat or Drop in 2025
The 2025 Medicare Physician Fee Schedule final rule, released Nov. 1, includes a conversion factor of $32.3465, a 2.83% drop from 2024. In response to advocacy efforts from the ACR and other medical societies, Congress recently introduced the Medicare Patient Access and Practice Stabilization Act of 2024, which would eliminate the 2.83% payment cut and provide an inflationary update for 2025 equal to 50% of the Medicare Economic Index.
CMS Updates the Medicare Conversion Factor
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.
2024 Remote Physiologic Monitoring and Therapeutic Monitoring Coding Guidance
This guidance from the ACR provides information about new remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) treatment management codes
UnitedHealthcare Working to Correct J Code Reimbursement Error
An error in UnitedHealthcare’s claims processing system resulted in underpayments on J code claims dated Oct. 8–Nov. 8, 2023. Practices are encouraged to review all J code payments from the final quarter of 2023.
We Want You: Your Role in the CPT Valuation Process
Accurate reimbursement for rheumatology services ensures rheumatologists can run successful practices and provide needed care, but only if they speak up through survey input to explain how much that care costs. Here’s how to participate in the process when rheumatology CPT codes come up for review.
Updates from the ACR Insurance Subcommittee Chair
The Insurance Subcommittee is working to address coverage and reimbursement challenges facing rheumatology practices. Recent activities include efforts to avoid increased administrative burden associated with specialty medications, support payer coverage of musculoskeletal ultrasounds and protect patient access to biologics.
Ethics Forum: Thoughts on Managing Electronic Communication with Patients
Recent proposals in the U.S. to bill for electronic communication with our patients could be seen as a refreshing but contested attempt to battle burnout rates in the present era. A fee for electronic communications between patients and clinicians also acknowledges the value of the clinician’s time and expertise. But is this ethical? Discussion Burnout…