HAP Radiology Billing and Coding Blog

Regulatory Issues Facing Radiology Groups In 2024 on February 23, 2024

We pay a lot of attention to government regulation in healthcare, especially the Medicare Physician Fee Schedule (MPFS) that influences reimbursement not only from Medicare, but also from other payers since many commercial contracts are tied to the MPFS. Although it is the object of most focus, the Centers for Medicare and Medicaid Services (CMS) is not the only agency that regulates healthcare.

Categories: MPFS, radiology, appropriate use criteria, information blocking, No Surprises Act

Appropriate Use Criteria (AUC) Penalty Phase Set to Begin on April 29, 2022

Will the requirement to use Clinical Decision Support (CDS) finally become a reality? The current timetable for the penalty phase of the AUC/CDS rule calls for it to begin on the later of January 1, 2023, or the January 1 following the end of the COVID-19 public health emergency (PHE). The PHE has just been extended another 90 days into July 2022, with no end in sight although there are some indications that it could end this year. One source reports that the Administration will give 60 days’ notice before ending the PHE. With this uncertainty, it would be wise for practices to be ready just in case!

Categories: interventional radiology, clinical decision support, CDS, radiology, appropriate use criteria, AUC

New Information on the Medicare Rules for Appropriate Use Criteria and Clinical Decision Support on July 24, 2017

New information has been provided by The Centers for Medicare and Medicaid Services (CMS) that will supplement our article An Update for Radiologists on Appropriate Use Criteria and Clinical Decision Support.  We can now update you from the recent release of the “Proposed Medicare Physician Fee Schedule (MPFS) for 2018” and the “Proposed Rule for Quality Payment Program Year 2.”

Categories: radiology reimbursement, clinical decision support, radiology, appropriate use criteria

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