Radiologists practicing in an imaging center or other non-hospital facility have a new tool available that will potentially allow them to recover some of the added costs related to safety precautions taken during the COVID-19 public health emergency. CPT code 99072 was added by the American Medical Association (AMA) Current Procedural Terminology (CPT®) Editorial Panel on September 8, 2020, with immediate effect. While payment for this code is not yet available from Medicare, it might be reimbursed by some commercial payers.
Can Radiologists Effectively Bill for COVID-Related Costs? on October 14, 2020
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.
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.
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.
Medicare Announces Prior Authorization Requirement on July 23, 2020
Radiologists who perform venous ablation in a hospital outpatient department are now required to obtain prior authorization before performing such services on Medicare patients. This new requirement became effective for services performed on or after July 1, 2020, and physicians were notified by letters from the Centers for Medicare and Medicaid Services (CMS) late in June. The prior authorization requirement was included in the 2020 Hospital Outpatient Prospective Payment System (HOPPS) Final Rule, and encompasses the following procedures that might be performed by interventional radiologists:
2020 Medicare Fee Schedule Valuation Changes & Radiology Practice Impact on February 26, 2020
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:
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.
Get Ready for Changes to Radiology Billing in 2020 on December 23, 2019
Our own Sandy Coffta, Vice President of Client Services, spoke with Aunt Minnie’s Brian Casey at the 2019 RSNA Annual Meeting in Chicago. In the interview posted on auntminnie.com, Sandy mentioned some of the highlights that practices should be concerned about in the coming year.
Update on Surprise Billing Legislation Across the Country on December 18, 2019
In the absence of federal regulation, states are adopting laws intended to protect patients from high out-of-pocket costs when they unexpectedly receive services from out-of-network (OON) providers. When a patient receives an unexpected bill following such OON services the situation is known as “surprise billing.” Not all OON billing falls into the category of “surprise billing,” however. In many cases, patients understand that the services they are receiving are OON and they expect to pay all or part of the bill.
The Value of PICC Lines for Interventional Radiologists on April 16, 2019
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.