When coding evaluation and management (E/M) services provided to a patient, one of the most persistent concerns is whether a patient is new or established to the practice. Although this may seem like a simple coding answer, the distinction is an important one, because it enables providers to appropriately bill and receive reimbursement correctly. E/M…
As of March 5, physicians no longer have to write their own notes in addition to notes created by students, residents or fellows during patient examinations; instead, providers will only have to verify information documented by the student. Early last month, the Centers for Medicare and Medicaid Services (CMS) reversed the Obama administration policy that prohibited…
LATE-BREAKING NEWS Editor’s note: The ACR praises Congressional leaders for passing today’s (2/9) sweeping spending agreement, which includes a technical provision reversing a Centers for Medicare & Medicaid Services (CMS) policy that would have linked physicians’ quality payment adjustments to Medicare Part B drug costs starting in 2019. The ACR also applauded the inclusion of…
On Dec. 8, 2017, members of the Cognitive Care Alliance (CCA)—of which the ACR is a leading member—met with members of Congress on the Hill and representatives from the Centers for Medicare and Medicaid Services (CMS) to discuss ongoing concerns about the inadequacy of existing evaluation and management (E/M) codes to properly remunerate cognitive services…
(Reuters)—A U.S. trade association representing medical laboratories filed a lawsuit on Monday challenging a new reimbursement system used by the federal government that it said would reduce how much Medicare pays for labs by about $670 million in 2018. The American Clinical Laboratory Association (ACLA) in a lawsuit in federal court in Washington, D.C., said…
Beginning in April 2018, Medicare patients will receive newly designed Medicare identification cards that replace their Social Security numbers (SSNs) with unique, randomly assigned, alphanumeric identification numbers. The Centers for Medicare & Medicaid Services (CMS) is making the change to protect patients 65 and older from exposing their SSNs in efforts to “help prevent fraud,…
Changes to reimbursement introduced by the Medicare Access and CHIP Reauthorization Act (MACRA) will affect your Medicare income for 2019. “Rheumatologists generally know that MACRA is up and running,” says Angus Worthing, MD, FACR, FACP, clinical assistant professor of rheumatology at Georgetown University Medical Center and chair of the ACR’s Government Affairs Committee. “Virtually every…
With the advent of biosimilars to the marketplace, the Centers for Medicare and Medicaid Services (CMS) now requires modifiers to identify the manufacturer of a biosimilar/biological product on Part B claims. Modifiers were put in place to provide the CMS with the necessary data needed to track claims payments, as well as the ability to…
WASHINGTON (Reuters)—The U.S. Centers for Medicare and Medicaid Services (CMS) said on Thursday it plans to spend $10 million on advertising for the upcoming Obamacare open enrollment period that starts in November, a sharp cut from the $100 million spent last year. The agency also said it will cut funding for so-called navigators, who help…
Believe it or not, change begins with one person willing to lead by example—and you can be that person. All too often, we get caught up with the changes we want. However, instead of talking about what we would like, it’s time to lead. The best way to do this is to show others you’re…