The American Medical Association and ACR Insurance Subcommittee offer support and guidance to help practices recognize and push back against downcoded payments for evaluation and management services.
Updated Coding Guidance for 2024 Remote Physiologic Monitoring & Therapeutic Monitoring
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.
After Pushback, Cigna Delays Modifier 25 Policy Changes
After significant pushback from the AMA, ACR and other medical societies, Cigna has delayed implementation of changes to its modifier 25 reimbursement policy, originally scheduled to take effect May 25.
CMS Releases CY23 Medicare Physician Fee Schedule & Quality Payment Program Updates
If enacted as is, the proposed CY 2023 Medicare Physician Fee Schedule and Quality Payment Program would make significant cuts to reimbursement for evaluation and management services, creating financial instability for providers. On a positive note, it would extend some telehealth flexibilities 151 days beyond the official end of the public health emergency.
ACR Overview of 2022 Medicare Physician Fee Schedule Final Rule
The final rule, issued Nov. 2, finalizes many policies in the July proposed rule, including the decreased conversion factor, billing for shared visits and teaching services, the continuation of telehealth services and inclusion of an ACR-led Merit-Based Incentive Payment System Value Pathway.
State-of-the-Art Clinical Symposium Premeeting Courses Feature Billing, Coding & Insurance Opportunities
Courses before the 2021 State-of-the-Art Clinical Symposium will focus heavily on what’s new in practice, including mastering evaluation and management changes and access to treatments in rheumatology. Early bird registration ends March 31.
Evaluation & Management Code Changes Set for 2021
Major changes to office and outpatient evaluation and management codes 99201–99205 and 99211–99215 will take effect Jan. 1, 2021.
Annual AMA Committee Meetings Present Large-Scale Survey Results on E/M Codes
The American Medical Association’s (AMA) Relative Value Scale (RVS) Update Committee (RUC) and Current Procedural Terminology (CPT) Committee currently meet three times a year each to keep the CPT code set up to date, and to review the valuation of all the codes for the physician fee schedule. The two-step meetings of both the CPT Editorial…
Training Is the Path for Documentation & Coding Improvement
Join us for the Rheumatology Documentation and Coding Workshop taking place during the 2019 State-of-the-Art Clinical Symposium, Friday, April 5 in Chicago. The Rheumatology Documentation and Coding Workshop will take a deep dive into the new Medicare coding and documentation requirements for evaluation and management coding, medical decision making and specificity in diagnosis coding. Due…
Update & Changes to the OIG Work Plan
Early last fall, the Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its OIG Work Plan for fiscal year 2018–2019, which is a two-year framework for the audits, inspections, evaluations and investigative activities planned in support of its vision, mission, and strategic goals and objectives to maintain HHS program integrity….