HAP Radiology Billing and Coding Blog

Regulatory And Payment Issues That Will Impact Radiology Practices In 2022 on November 23, 2021

Keeping abreast of the various healthcare rules and regulations from federal and state authorities can sometimes be overwhelming for a practice’s management. Here is a summary of some of the most important regulatory issues to be aware of for next year, along with a few payment policy decisions that are not governmental. The links will take you to our recent articles and other sources that probe each topic in more depth.

Categories: cms, MPFS, low dose CT, CPT codes, radiology, QPP, surprise billing

CMS Has Released The 2022 Medicare Physician Fee Schedule Final Rule on November 16, 2021

Coming a bit earlier in the month than usual, the release of the Medicare Physician Fee Schedule (MPFS) Final Rule for 2022 contains few changes from the rule proposed earlier this year. The Proposed Rule reported a 2022 Conversion Factor (CF) of $33.5848 per Relative Value Unit (RVU), but the Final Rule adjusts the figure slightly upward to $33.5983. This is a reduction of 3.71% from the 2021 CF of $34.8931. In addition to this cut, practices will see an additional 2% payment reduction when sequestration resumes on January 1, 2022.

Categories: cms, MPFS, Quality Payment Program, radiology, quality measures, Medicare Physician Fee Schedule

More Evidence That Radiology is Not the Source of Medicare Spending Increases on September 22, 2021

It seems that diagnostic imaging and radiology are often blamed for increasing the cost of healthcare, especially Medicare costs. Not so, says a recent study that was reported in Radiology Business on August 30, 2021.

Categories: medicare, cms, radiology

Medicare’s Proposed Rule For 2022 Has Few Changes for Radiology, but Likely a Cut in Reimbursement on July 27, 2021

The Centers for Medicare and Medicaid Services (CMS) has released its proposed changes to the Medicare Physician Fee Schedule (MPFS) for 2022. The Proposed Rule is usually modified somewhat before it becomes the final rule for each year, but it gives an idea of the direction Medicare reimbursement is headed. The Medicare Proposed Rule contains payment policy decisions as well as changes to the Quality Payment Program (QPP).

Categories: cms, MPFS, radiology

Low-Dose CT (LDCT) Lung Cancer Screening Guidelines Are Changing on July 21, 2021

Based on revised recommendations from the US Preventative Services Task Force (USPSTF), the Centers for Medicare and Medicaid Services (CMS) is considering an adjustment to its reimbursement policy for LDCT Lung Cancer Screening. CMS expects to complete its decision-making process before February 2022. In the meantime, many commercial payers have already expanded coverage by adopting the new recommendations.

Categories: radiology reimbursement, cms, radiology, lung cancer screening

Update on The Quality Payment Program on March 17, 2021

The Quality Payment Program (QPP) continues to be modified due to the COVID-19 public health emergency. The Centers for Medicare and Medicaid Services (CMS) recently announced some leeway for clinicians affected by the pandemic in 2020 and 2021.

Categories: radiology reimbursement, cms, QPP, COVID-19

Major Cut in Radiology Reimbursement For 2021 Is Finalized By CMS on December 7, 2020

The Centers for Medicare and Medicaid Services (CMS) has released the final set of rules that will govern the Medicare payment system for the coming year, thereby affirming the drastic cut in radiology reimbursement for 2021 that was proposed earlier this year.  There were few surprises in the Medicare Physician Fee Schedule (MPFS) Final Rule that were not contained in the proposed rule, other than a slight improvement in the fee schedule conversion factor and a change to the QPP Performance Threshold.

Categories: radiology reimbursement, cms, MPFS, radiology, QPP

Federal Provider Relief Programs Are Continuously Changing on October 9, 2020

The COVID-19 pandemic spawned many programs designed to assist medical practices to stay afloat financially through the duration of the public health emergency. The terms and conditions of many of the various relief programs have changed since they were first introduced, and it often is a challenge to keep up with the latest rules. The Department of Health and Human Services (HHS) has now announced another round of Provider Relief Funding (PRF) and the terms of the Medicare Accelerated and Advanced Payment Program have recently been modified.

Categories: cms, COVID-19, HHS

Get Feedback on Your 2019 Quality Payment Program Performance on September 22, 2020

Quality Payment Program (QPP) participants can now obtain information about whether their practice will receive a positive, negative, or neutral Medicare fee schedule adjustment in 2021 based on the 2019 data they submitted. The Centers for Medicare and Medicaid Services (CMS) announced that clinicians who participated in the Merit-based Incentive Payment System (MIPS) in 2019 can access their performance feedback by logging in to the Quality Payment Program website

Categories: radiology reimbursement, physician reimbursement, cms, Quality Payment Program, QPP, quality measures

Medicare Delays Recoupment of Advances on September 10, 2020

One of the fastest and easiest sources of emergency funding available to practices at the outset of the COVID-19 pandemic was the Medicare Accelerated and Advanced Payment Program.  As we recently reported, the initial timetable called for repayment of those advances to begin 120 days after the advance was made. Repayment was to be accomplished through reduction of Medicare reimbursements otherwise payable to the practice currently, until the full amount of the advance was repaid.

Categories: medicare, medicare reimbursement, cms, radiology, COVID-19

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