The Medicare and Medicaid provider auditing process is about to get a makeover in 2025. I am talking about artificial intelligence (AI), which may be more accurate than our auditors,…
Following the Furthering Access to Stroke Telemedicine (FAST) Act, Medicare claims for telestroke services increased in rural and urban emergency departments. However, there was still substantial underbilling from hospitals with…
Medicare intends next year to allow physician assistants (PAs) to begin directly billing for their work and to expand coverage of telehealth services. It also intends to change the approach…
CMS has raised the Medicare payment rate for certain COVID-19 antibody infusions and included a new payment policy for at-home administration, which will have a higher payment rate compared to…
Provider groups are concerned that some proposals in the Medicare Physician Fee Schedule rule for 2021 would exacerbate the financial challenges physicians are already facing during the COVID-19 pandemic, including…
Where the burden lies could make a difference when it comes to the RACs. In a legal lawsuit, one party is initially presumed to be correct and gets the benefit…
Clinical diagnostic laboratory tests range from routine chemical measurements like blood glucose or sodium to complex examinations for cancer, infectious diseases, or rare inherited disorders. The information they provide is…
Providers are calling on CMS to not finalize a proposal to collapse Medicare reimbursement for evaluation and management (E/M) visits into a single, blended payment rate for E/M Levels 2…
Louisiana posted the highest rate of Medicare being overbilled for services in the nation in 2015, with providers charging an estimated $1.25 billion more than they should have, according to…
Closing in on two hours before the midnight deadline, the U.S. Senate on Tuesday April 14th, 2015 passed the bill in a vote of 92 to 8 to permanently end…
Medicare audits have revealed recurring errors in billing with add-on and place-of-service codes. In addition, Medicare continues to receive claims that appear to be duplicate because they lack an appropriate modifier. Here are some guidelines for correct billing.
The Centers for Medicare & Medicaid Services (CMS) issued the 2015 Medicare Physician Fee Schedule (Medicare PFS) on October 31, 2014.
A proposed rule that was expected to outline how Medicare's interest should be protected in cases of settlements for future medical care was withdrawn Oct. 8 by the Office of Management and Budget.
What happened to Eastern Carolina internal Medicine (ECIM) in Pollocksville, North Carolina is a provider’s nightmare about government oversight run amok. A Medicare audit began as a medical records request.…
The CMS is practicing what it preaches: The agency decided to open several large data sets for consumers, researchers and entrepreneurs to use. The announcement was made at this week's…
For the first time, the federal Centers for Medicare and Medicaid Services (CMS) has made public a database showing what it pays out to individual physicians. In a press release,…