At around this time last year we were beginning to learn about the various ways medical practices could make use of federal programs to help keep them afloat through the COVID-19 pandemic. No one knew how long it would last. As time went on, we followed the changes to those programs, the new programs that became available, and the deadlines for action. Let’s review the latest federal legislation and also where each of last year’s relief programs stands today, especially the Medicare Payment Sequester that is a developing story.
Categories:
medicare,
radiology,
teleradiology,
PPP
When the Medicare Physician Fee Schedule (MPFS) Final Rule was published in December, it looked like radiology was facing a significant cut in Medicare reimbursement for 2021. Our article reported that professional component fees would drop 10-11% while global reimbursement would see a lesser impact. The Consolidated Appropriations Act, 2021 (CAA) rolled back those cuts at least for 2021, although the Medicare fee schedule for radiology will likely continue to be adjusted downward in the future as implementation of the revalued Evaluation and Management (E&M) services is fully phased in.
Categories:
radiology reimbursement,
medicare,
medicare reimbursement,
MPFS,
radiology
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
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
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
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
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
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
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
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
