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.
The Biosimilar Economic Conundrum: Where We Stand
Reimbursement has fallen below acquisition price for some biosimilar versions of infliximab, forcing practices and patients to make difficult decisions. The ACR is working to change this.
Community Practice Rheumatology Is Challenging, But Rewarding, Too
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…
Advancing the Work of CORC: Q&A with New Chair Chris Phillips, MD
New Committee on Rheumatologic Care (CORC) Chair Chris Phillips, MD, talks about his past work with the ACR, his experience as a private practice rheumatologist and his plans to lead CORC in addressing practitioner pain points and supporting the business side of rheumatology practice.
Blue Cross NC Revises Autoimmune Pathways Program
After meeting with the ACR and other stakeholders, Blue Cross NC and OMI announced revisions to their Autoimmune Pathways Program to drop biologic tapering requirements and paying providers according to specific treatment decisions.
ACR Advocates with Payers Against Insufficient Reimbursement for Biosimilars
The ACR is engaging with payers regarding formulary requirements that would leave practices underwater when treating patients with rheumatic diseases.
Ask Congress to Support Complexity Add-on Code
Implementation of the G2211 add-on code for evaluation and management services is included in the CY 2024 Medicare Physician Fee Schedule, barring further delays. Ask your lawmakers to support timely implementation and patient access to complex care.
Ethics Forum: Mitigation Tips for Health Disparities Among Rural & Indigenous Peoples
A common case scenario in our practice in North Dakota is a woman with rheumatoid arthritis on methotrexate monotherapy. She is a member of the Sisseton Wahpeton Oyate people and lives 90 miles from our rheumatology clinic. She currently has moderate disease activity, indicating the need for additional treatment. She does not have her own…
ACR’s Community Practice Council Supports Independent Practitioners
Forging one’s own path after completing medical training can be daunting. As I entered the final six months of my rheumatology fellowship, I was also pregnant with my first child. Having grown comfortable within academic settings, I felt the nerves of trying to find my place outside medical education. Search for Home For the best…
Nurse Practitioners Deliver as Part of the Rheumatology Team
The upcoming 2023 Nurse Practitioner Week, Nov. 12–18, was good reason for Debbie Durkee, RN, MSN, FNP-C, to reflect on the profession and its growth, her years in practice, and the importance of active participation in the ARP. Unlike many who go into the field, Ms. Durkee never felt drawn to nursing as a child,…
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