In the early 1900s, the treatment for rheumatic and musculoskeletal disease (RMD) was primarily targeted at symptomatic relief and included analgesics, physical therapy, splinting and bed rest. With the discovery of methotrexate and its impact on rheumatoid arthritis (RA) management, a much-needed evolution of medications targeting disease activity began. Over the past 30 years, several…
Prior Authorization Woes: Barriers to & Delays in Care, Administrative Hassles & Potential Solutions
As insurers phase out pandemic-related flexibilities, many are raising new obstacles to try to limit their financial exposure.
UHC Updates Policy on Reimbursement for Incident-to Services
On Aug. 1, UnitedHealthcare implemented a new policy on Services Incident-to a Supervising Health Care Provider that allows for appropriate reimbursement for “incident-to” services consistent with current Medicare guidelines.
Will an App to Monitor Patient Outcomes Improve RA Disease Activity?
Lee et al. examined the use of a smartphone application to monitor longitudinal electronic patient-reported outcomes on satisfaction and disease activity in patients with RA.
2022 Physician Fee Schedule Proposed Rule Released
In the proposed rule released July 13, the ACR is encouraged by the continued implementation of evaluation and management reimbursement adjustments to better reflect the work and expertise needed to treat complex patient populations, the extension of many telehealth flexibilities and the inclusion of the ACR’s proposed MACRA MIPS Value Pathway for rheumatology.
2022 Proposed Rule for the Quality Payment Program Released
ACR staff have highlighted critical changes for the 2022 performance year outlined in the proposed rule released July 13 by the Centers for Medicare & Medicaid Services.
The Power of Mentorship in the Cultivation of Advanced Practice Providers
“The task of the modern educator is not to cut down jungles but to irrigate deserts,” said mid-20th century scholar and writer C.S. Lewis. Although he was speaking to the importance of the holistic education of students, the same idea rings true for a 21st century nurse practitioner (NP) new to rheumatology. Indeed, the care…
High Cost of Specialty Drugs Demands Action
Amid rising drug costs and the growing influence of pharmacy benefit managers on patient care decisions, physicians are increasingly called upon to advocate for affordable, evidence-based treatments for their patients.
Bipartisan DXA Bill Under Consideration in Congress
The Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act would set a $98 floor for Medicare reimbursement for the dual-energy X-ray absorptiometry (DXA) bone density test.
Coding & Reimbursement Guidelines for Interprofessional Consultation Codes
Current Procedural Terminology (CPT) codes 99446–99449 were created in 2014 to capture the time spent by a consultant who is not in direct contact with the patient at the time of service. An interprofessional telephone/internet consultation (ITC) is defined as an assessment and management service in which a patient’s treating provider (e.g., primary or qualified…
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