In August 2014, the Centers for Medicare & Medicaid Services issued a National Coverage Determination (NCD) for transcatheter mitral valve repair (TMVR). This decision memo stated CMS would cover TMVR for mitral regurgitation (MR) under Coverage with Evidence Development (CED) for the treatment of MR when furnished for an FDA-approved indication with an FDA-approved device […]
Free Mental Health Resource: Tips and Strategies for Billing From SPRC
The Suicide Prevention Resource Center (SPRC) provides numerous valuable and free primary care resources on its website. Included in these resources is a five-page guide on “Tips and Strategies for Billing for Mental Health Services in a Primary Care Setting.” Topics covered in this guide include: How to bill for diagnostic and treatment services Tips […]
8 Statistics on EHR Adoption
Here are eight interesting statistics on electronic health records software adoption in physician offices, according to SK&A’s annual “Physician Office Usage of Electronic Health Records Software” (pdf) report. 1. From 2013 to 2014, physician office usage of electronic health records increased more than 10 percentage points in solo and smaller practices. 2. Overall EHR adoption […]
Wrongful Denial of Health Claims Harms Providers and Patients
Every time a health claim is denied, an insurance company makes more money. But it’s no “wonderful life” for healthcare providers and patients when faced with a denied claim. Claim denials create significant challenges for both parties. For providers, claims follow up is a time-consuming, costly and often unsuccessful process. For patients, a denied claim […]
Billing Tip: Ensure Visits Billed as ‘Incident To’ Meet Medicare Criteria
The U.S. Department of Health and Human Services (HHS) is more closely scrutinizing services billed at physician reimbursement levels but performed by nonphysicians, according to a Medical Economics report HHS indicated its intention to take a closer look at these “incident-to” services, which are often performed by nurse practitioners and physician assistants, in its Office […]
Physical Therapy Services Facing Reimbursement Cuts
The passage of the American Taxpayer Relief Act of 2012 includes the addition of a provision that will reduce Medicare reimbursement to physical therapists come April 1, 2013, according to the American Physical Therapy Association. The decline would be slightly offset, but the bottom line is physical therapists will see a reduction in Medicare reimbursement […]