As part of the COVID relief and appropriations package signed into effect Dec. 27, Congress took steps to mitigate significant fee schedule reductions for several specialties that were designed to offset payment boosts for evaluation and management (E/M) services....
FYI: This post originally ran in October 2020 when UHC first announced this move. We have bumped it to the top of our blog as a reminder the policy change is now in effect. After making the move to align prostate biopsies with G0416 for Medicare Advantage plans...
After a lengthy delay, CMS released the 2021 Medicare Physician Fee Schedule Final Rule Tuesday. It finalizes several telehealth flexibilities introduced during the public health emergency while also significantly overhauling reimbursements for evaluation and...
A pair of Final Rules issued recently by CMS and the OIG establishes new safe harbors aimed to promote value-based care, while also modifying some of the existing safe harbors. CMS said the intent behind the new rules, which were first proposed in 2019, is to allow...
ACO Accountable Care Organization: A model for patient population management APC Ambulatory Patient Classifications: The government’s method for paying for outpatient services for the Medicare program. APM Alternative Payment Model: These are the new payment models...
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