HAP Radiology Billing and Coding Blog

Medicare Delays Recoupment of Advances

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

Radiology’s Declining Reimbursement Spans More Than A Decade

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.

Categories: radiology reimbursement, medicare, medicare reimbursement, MPFS, radiology

Medicare Proposed Major Cut in Radiology Reimbursement for 2021

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.

Categories: radiology reimbursement, medicare, medicare reimbursement, cms, radiology

Relaxed Telehealth Regulations for Radiologists in the Wake of COVID-19

This article was updated on
April 14, 2020. 


Medicare has temporarily opened up the ability for physicians to provide medical care to patients without the need for them to be in the same physical location.  Beginning  March 2020 and continuing through the end of the current COVID-19 Public Health Emergency (PHE), the rules for providing telehealth services have been relaxed.  Is there any opportunity for radiologists to use telemedicine in their practice? 

Categories: medicare, medicare reimbursement, cms, teleradiology billing, teleradiology

2020 Medicare Fee Schedule Valuation Changes & Radiology Practice Impact

In the final 2020 Medicare Physician Fee Schedule (MPFS), fee increases relevant to radiology overall outnumbered decreases.  However, many of those increases were insignificant changes of less than 1%.  There were 128 Professional Component (PC) codes decreased by more than 1%, with only 76 increased, while 430 Global codes increased by more than 1% and 346 Global codes decreased.  Here are the details:

Categories: radiology reimbursement, radiology billing, medicare reimbursement, MPFS, interventional radiology billing

How the Medicare Final Rule For 2020 Will Affect Radiologists

The Centers for Medicare and Medicaid Services (CMS) has released the annual changes to the Medicare Physician Fee Schedule (MPFS) in its Final Rule that contains not only adjustments to Medicare reimbursement but also revisions to the Quality Payment Program (QPP) for 2020 and beyond.   The MPFS Final Rule does not contain very many significant changes for the coming year, especially for radiology, but one of its provisions will have a far-reaching effect on radiology beginning in 2021. 

Categories: medicare, medicare reimbursement, cms, MPFS, radiology, QPP, quality measures

First Look at the New Medicare Rules for 2020

The Centers for Medicare and Medicaid Services (CMS) released their annual proposal for changes to the Medicare payment system for the coming year, and they also released new information about the existing mandate for the use of Clinical Decision Support (CDS) beginning in 2020.  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 2020 and beyond.

Categories: medicare, medicare reimbursement, MPFS, Quality Payment Program, radiology, QPP

Update on Interventional Radiology Coding and Billing

Proper coding of physician services is essential to efficient billing and the optimization of reimbursement from payers, including commercial and governmental entities.  The CPT® codes issued by the American Medical Association (AMA) to describe physician procedures are supposed to be recognized as standards, but in practice they are not accepted equally by all payers.  One example is CPT codes in the range 99241-99255 that describe consultation services.  These are most often used by interventional radiologists, as described in our article Coding and Billing Considerations in Interventional Radiology.

Categories: radiology billing, medicare, medicare reimbursement, interventional radiology, radiology, interventional radiology billing

The Value of PICC Lines for Interventional Radiologists

Interventional radiologists are often called to perform peripherally inserted central venous catheter (PICC) prodecures.  Recent coding and policy changes bundle all imaging guidance and the confirmation of final placement into a single CPT® code.  Let’s review the financial implications of those changes.

Categories: radiology reimbursement, medicare reimbursement, interventional radiology, PICC

Coding Changes That Will Impact Radiology Practices In 2019

Click here to read our 2020 code changes update article. 

 

Each year there are revisions of Current Procedural Terminology[i] (CPT)® that will impact the way radiology practices code their procedures and, ultimately, how they are reimbursed for those procedures.  The majority of CPT code changes in radiology for 2019 are for Interventional Radiology procedures.  Those that pertain to diagnostic radiology are in ultrasound, MRI, and nuclear medicine.  We’ll cover the diagnostic codes first, and then go into detail on the interventional coding changes.

Categories: medicare, medicare reimbursement, interventional radiology, MPFS, CPT codes, radiology, diagnostic radiology

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