The Centers for Medicare & Medicaid Services' (CMS') proposed calendar year 2025 physician fee schedule rule, out Wednesday, proposed an assortment of new payments and coverage for digital health services,…
An unprecedented number of individuals are now enrolled in Patient Protection and Affordable Care Act (PPACA) Marketplace health insurance plans – and federal officials this week signaled that the trend…
While CMS (the Centers for Medicare & Medicaid Services) usually releases new rules in the afternoon, on July 10 they chose to release the 2025 Outpatient Prospective Payment System (OPPS)…
Sea Chen, MD, PhD, remembers when his practice’s business office failed to notify others in the clinic about some denied claims and the reasons behind them. “Because of this, we…
A recent proposal to report prior authorization to insurance plans through CPT codes was withdrawn at the eleventh hour when its physician advocate made an unexpected discovery: For certain codes…
As we begin the second half of the year, it is a convenient time to make plans and take stock of our coding operations. There will be much to do…
In a landscape where patients are responsible for an ever-growing share of healthcare costs, traditional billing practices are falling short as consumers fall farther behind on their payments. Reversing this…
Most physicians wish they could spend less time writing clinical notes. But experts say that the time and energy needed to develop or learn to use new templates can discourage…
The Centers for Medicare & Medicaid Services (CMS) has announced that payments under the Accelerated and Advance Payment (AAP) Program for the Change Healthcare/Optum Payment Disruption (CHOPD) will conclude on…
The new ICD-10-PCS codes for the 2025 fiscal year (FY) were posted on the Centers for Medicare & Medicaid Services website on June 6. The Version Summary reflects 371 new…
The US health care industry continues a predominant fee-for-service provider reimbursement model, despite trying to shift to a value-based care model for now approaching two decades. Moreover, providers continue to…
A push to improve reimbursement for remote patient monitoring programs has stalled, and that could prompt health systems and hospitals to think twice about launching or expanding their platforms. The…
I recently saw a notable update on the Trusted Exchange Framework and Common Agreement or TEFCA, a federal program intended to improve health data interoperability across the healthcare industry. …
Excessive clinical documentation is a widespread problem that is causing clinician burnout and even having an impact on patient care – as an American Medical Informatics Association survey recently showed.…
CPT code +69990 Microsurgical techniques requiring use of operating microscope is assigned when a surgeon uses an operating/surgical microscope to aid in visualizing small/fine structures in the operating field during…
The Centers for Medicare & Medicaid Services (CMS) has proposed an episodic payment model, the Transforming Episode Accountability Model (TEAM). This is one of CMS’s “innovation” models. If it makes…