COVID-19 Relief Bill Adds Surprises to 2021 Final Rule, MPFS
The conversion factor was increased twice in one week. The Centers for Medicare & Medicaid Services (CMS), in a rare move, recently raised the conversion factor (CF) twice in one…
The conversion factor was increased twice in one week. The Centers for Medicare & Medicaid Services (CMS), in a rare move, recently raised the conversion factor (CF) twice in one…
CMS clearly is honing-in on reducing administrative burden as changes go into effect. On Friday, Nov. 1, the Centers for Medicare & Medicaid Services (CMS) released the Medicare Physician Fee…
Another day, another change to E/M plans for 2021! Medicare has released the 2020 proposed rule for the Medicare Physician Fee Schedule (MPFS), bringing in the recent AMA plan to…
There are nine different Multiple Procedure indicators on the Medicare Physician Fee Schedule (MPFS), meaning there are a lot of payment adjustment possibilities you need to know. Here’s each indicator,…
The Centers for Medicare & Medicaid Services (CMS) Transmittal 1058, Change Request (CR) 7767 confirms a zero percent update for payments under the Medicare Physician Fee Schedule (MPFS) through year’s end.
Pediatricians who were thrilled with CPT 2011’s move to paying vaccines per component got a setback from Medicare’s rejection of the recommended RVUs for new vaccine administration codes 90460 and 90461.
The Relative Update Committe recommended that the 2011 Medicare Physician Fee Schedule and Resource Based Relative Value Scale assign 0.20 practice expense (PE) RVUs to 90460 and 0.16 PE RVUs to 90461. But CMS disagreed with the proposal. “We disagree with the recommendations and will maintain 0.17 RVUs for code 90460 and 0.15 RVUs for code 90461 since these codes would be billed on a per toxoid basis,” said Kenneth Simon, MD, MBA, Senior Medical Officer, Center for Medicare and AMA CPT Editorial Panel Member, in “Medicare Physician Payment Schedule 2011 Changes and Beyond” at the CPT® and RBRVS 2011 Annual Symposium on Nov. 10, 2010.
The increased PEs represent an increase in RVUs from the 2010 values for comparable codes 90465/90467 and 90466/90468. The RUC requested the increase in value due to increased time for patient education. Since the new codes are valued per component, CMS felt no increase was warranted.
CMS assigned RVUs to 90460 and 90461 by crosswalking them with the values of the noncounseling vaccine administration codes 90471 and 90472. This means that new code 90460 has the same RVUs as 90471, and each unit of 90461 has the same RVUs as 90472.
The work and total RVUs for the codes include:
Code | PE RVU RUC Proposed | PE RVU MPFS Accepted | Total RVUs |
90460 | 0.20 | 0.17 | 0.59 |
90461 | 0.16 | 0.15 | 0.3 |
90465 | <td width="203"
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You can sit back and enjoy the fall foliage spectacle — SuperCoder.com’s got your ICD-9-CM 2011, National Correct Coding Initiative 16.3, and October Medicare Physician Fee Schedule medical coding updates covered. Go ahead and search for th...
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