HAP Radiology Billing and Coding Blog

Coding Changes That Will Impact Radiology Practices In 2019 on January 2, 2019

Click here to read our 2024 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

Review of The Medicare Quality Payment Program for 2019 on November 19, 2018

With the publication of the Medicare Physician Fee Schedule (MPFS) Final Rule for 2019, which includes the Quality Payment Program (QPP) Final Rule, we can now review how radiologists can prepare to maximize their 2021 Medicare reimbursement through QPP participation in 2019.  The QPP includes both the Medicare Incentive-based Payment System (MIPS) and Alternative Payment Model (APM) tracks.  Since most radiology groups are currently participating in MIPS, we will focus on steps to take for successful participation in this program.

Categories: MPFS, MIPS, Quality Payment Program, radiology, QPP, APM

The Final Rule for Medicare’s Physician Fee Schedule is In Place For 2019 on November 12, 2018

The final rule for the 2019 Medicare Physician Fee Schedule (MPFS) issued by the Centers for Medicare and Medicaid Services (CMS) accepts many of the proposals made earlier this year but some are modified or delayed.

 

Watch our MPFS 2019 Updates Webinar

Categories: MPFS, radiology

A Review of the ACR’s Comments On The Medicare Physician Fee Schedule Proposed Rule For 2019 on September 25, 2018

The American College of Radiology (ACR) does a very thorough job of reviewing and commenting on proposed federal legislation such as the annual changes to the Medicare Physician Fee Schedule (MPFS).  Their 59-page letter of September 10, 2019 to Seema Verma, Administrator 
of the Centers for Medicare & Medicaid Services (CMS), is available on the ACR website for radiologists to review in detail. 

Categories: radiology reimbursement, MPFS, radiology

How the Proposed Medicare Fee Schedule Changes Will Impact Radiology Practices on August 28, 2018

CMS, the Centers for Medicare and Medicaid Services, is constantly on the lookout for procedure codes that it feels do not reflect the current cost or complexity of practice in their valuation.  The annual Medicare Physician Fee Schedule (MPFS) rule modifies many codes with varying degrees of impact to radiology practices. 

Categories: radiology reimbursement, interventional radiology, MPFS, radiology

What the MPFS Proposed Rule for 2019 Means for Radiologists on August 6, 2018

The Centers for Medicare and Medicaid Services (CMS) has combined its rule making for both the Medicare Physician Fee Schedule (MPFS) and the Quality Payment Program (QPP) into one document for its 2019 proposal.  This article will summarize the elements of each area that will most affect radiology practices if they are ultimately finalized and become law later this year. 

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

How the 2018 Coding Changes Will Affect Radiology Practices on December 15, 2017

Click here to read our 2024 code changes update article.

 

The recently issued Medicare Physician Fee Schedule (MPFS) Final Rule for 2018 tells us which of the revisions to the Current Procedural Terminology[i] (CPT)® have been adopted for use in the Medicare system, and how Medicare values those codes.  The diagnostic radiology changes are fairly straightforward, but the Interventional Radiology (IR) coding for Endovascular Repair has been drastically altered with 20 new or revised codes. 

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

Regulatory Changes Affecting Radiology Reimbursement in 2018 on December 7, 2017

The regulations that will affect Medicare reimbursement for physician practices in 2018 have been released.  They include the Medicare Physician Fee Schedule Final Rule  (MPFS), the hospital Outpatient Prospective Payment System Final Rule (OPPS), and the Quality Payment Program Final Rule (QPP). 

Categories: medicare, medicare reimbursement, MPFS, QPP, OPPS

CMS Issues Its Proposed 2018 Medicare Physician Fee Schedule Rule on July 25, 2017

The annual regulatory cycle of review, comment, planning and preparation has begun with the release of the Medicare Physician Fee Schedule (MPFS) Proposed Rule for 2018. In its preliminary review of those sections of the MPFS that will be of specific interest to radiology practices, The American College of Radiology (ACR) includes a statement that “the ACR is pleased with several provisions within the rule.”  They highlight the planned implementation of the Appropriate Use Criteria and Clinical Decision Support rules beginning January 1, 2019 and the proposal to leave the technical component of mammography services unchanged rather than lowering it by 50% as previously discussed. 

 

Categories: radiology reimbursement, cms, MPFS, radiology

CMS Issues Its Proposed 2017 Medicare Physician Fee Schedule Rule on July 18, 2016

The Centers for Medicare and Medicaid Services (CMS) has issued its proposed revisions to the Medicare Physician Fee Schedule (MPFS) for 2017, thus beginning the annual cycle of review, comment, planning and preparation that goes along with this release.  Missing from this year’s proposed rule are provisions related to the Medicare quality reporting programs (PQRS, VM, MU-EHR*) that have been a large part of the rule in recent years. 

Categories: radiology reimbursement, MPFS

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