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...
When CMS announced its intent to reduce payments for high-throughput COVID-19 tests next year while offering providers a path to be made whole if they met new turnaround time targets, several questions arose concerning how the agency intended to monitor its new...
As of Oct. 1, MOLDX has updated their LCDs/Billing and Coding Articles for the Multiplex Nucleic Amplified Tests for Respiratory Panels to no longer cover the PLA codes 0098-0099U, U100U, and 0115U. These PLA codes represent respiratory panels using BioFire® or...
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