HAP Radiology Billing and Coding Blog

How the Consolidated Appropriations Act Will Impact Radiology Practices on January 18, 2021

The “Consolidated Appropriations Act, 2021” (CAA) is a sweeping piece of legislation that provides relief to individuals and businesses impacted by the COVID-19 public health emergency. Some of the relief provisions apply to all businesses, including medical practices, but it also contains several measures that specifically apply to medical practices.

Categories: radiology reimbursement, medicare, medicare reimbursement, radiology, surprise billing, Paycheck Protection Program

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

Radiology’s Declining Reimbursement Spans More Than A Decade on August 20, 2020

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 on August 14, 2020

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

Early Pandemic Funding Sources May Require Action Now on July 30, 2020

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.

Categories: medicare, COVID-19, HHS

Expansion of the Accelerated & Advance Payments Program for Providers & Suppliers During the COVID-19 Emergency on March 31, 2020

With the expanded eligibility of the Medicare Accelerated Payment Program, additional entities will now qualify for, essentially, an interest-free loan. Within the CARES Act, physicians and other Medicare Part B Suppliers are now eligible to receive a needed increase to cash flow during the COVID-19 pandemic. (Supplier is a physician or other practitioner that delivers health care services under Medicare, excluding a provider).

Categories: medicare, CARES Act, COVID-19

Relaxed Telehealth Regulations for Radiologists in the Wake of COVID-19 on March 20, 2020

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

What the January 2020 Update to the Medicare AUC/CDS Mandate Means for Radiologists on January 29, 2020

It’s a cold January here in the northeastern US, so it’s a good time to heat up plans to comply with the Medicare AUC Mandate!  We have entered the official Educational and Operations Testing Period of 2020, which means that Medicare is ready to accept the Appropriate Use Criteria (AUC) modifiers and G-codes on claims now being submitted.  Let’s first review what this Medicare mandate means and then make plans to get it operational in your practice.

Categories: radiology reimbursement, medicare, cms, CDS, AUC

How the Medicare Final Rule For 2020 Will Affect Radiologists on November 15, 2019

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 on August 13, 2019

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

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