HAP Radiology Billing and Coding Blog

The average cut of 11% in radiology reimbursement that is proposed by the Medicare Physician Fee Schedule for 2021 (MPFS) is the continuation of a trend that spans more than a decade.

The Centers for Medicare and Medicaid Services (CMS) has released their annual proposal for changes to the Medicare payment system for the coming year. The Medicare Physician Fee Schedule (MPFS) Proposed Rule contains not only proposed adjustments to Medicare reimbursement but also proposed changes to the Quality Payment Program (QPP) for 2021 and beyond.

Much has been written about the Paycheck Protection Program (PPP) loans and the complex rules for loan forgiveness, but there were other funding sources available early in the public health emergency that need to be revisited now.   Our article in April outlined the HHS Grant Funds and another article discussed the Medicare Accelerated & Advance Payments Program.

Radiologists who perform venous ablation in a hospital outpatient department are now required to obtain prior authorization before performing such services on Medicare patients.  This new requirement became effective for services performed on or after July 1, 2020, and physicians were notified by letters from the Centers for Medicare and Medicaid Services (CMS) late in June.  The prior authorization requirement was included in the 2020 Hospital Outpatient Prospective Payment System (HOPPS) Final Rule, and encompasses the following procedures that might be performed by interventional radiologists:

Since the end of March we all have been focused on the impact of the public health emergency created by the COVID-19 pandemic, but slowly our attention is returning to the other ongoing issues of operating a practice.  Let’s review some important topics that still exist on our radar screens.

We now have more concrete details about the revisions to the Paycheck Protection Program (PPP) that were outlined in our recent article following passage of the Paycheck Protection Program Flexibility Act (PPPFA).  The PPP Loan Forgiveness Application (SBA Form 3508) has been revised and a new simplified application (SBA Form 3508EZ) is also available, along with instructions, from the SBA website. 

The first article in our three-part series covered workplace safety policies, changes to your office space, and workflow processes, while the second article discussed human resources and patient scheduling considerations.  In this final article, we look at ways to strengthen the return of patient volume to your practice through community collaboration and marketing.

The first article in our three-part series covered workplace safety policies, changes to your office space, and workflow processes.  Next, we will discuss the many aspects of human resource management and address patient scheduling in this new environment. 

On June 3, 2020, Congress passed the Paycheck Protection Program Flexibility Act of 2020 (PPPFA) that modifies the Paycheck Protection Program (PPP) that was put in place as part of the Coronavirus Aid, Relief and Security (CARES) Act.  The PPP is a potentially forgivable loan administered by the Small Business Administration (SBA).  This latest legislation changes some of the terms and requirements that will lead to loan forgiveness as we outlined in our recent article. 

There are many variables to consider in addressing the uncertainties that lie ahead. While we know there is a lot of excellent information available, our hope is that we have been able to curate some relevant guidance that will help your practice thrive again in this period of uncertainty.  Areas of focus for your practice should include: