A new report by Grand View Research examines the growth of medical billing outsourcing. Grand View projects the outsourcing market to grow by more than 150% from 2015 to 2024. Here are five of the factors that will contribute to the significant growth, according to Grand View: Current systems in practice for managing revenue are […]
CMS Publishes Video on Psychotherapy and Psychiatry Billing
The Centers for Medicare & Medicaid Services (CMS) has published a video on provider compliance relating to psychotherapy and psychiatry medical billing. The video includes pointers to properly submit documentation for these services, more specifically the use of add-on codes when billing for same day evaluation and management and psychotherapy services, and three factors needed […]
CMS Releases Final Rule on Lab Billing and New Payment System
The Centers for Medicare & Medicaid Services (CMS) has released a final rule requiring laboratories performing clinical diagnostic laboratory tests to report the amounts paid by private insurers for laboratory tests. Medicare will then use these private insurer rates to calculate Medicare payment rates for laboratory tests paid under the Clinical Laboratory Fee Schedule (CLFS) […]
Happy Medical Biller’s Day!
Governors from multiple states (including Alabama and Virginia) have declared March 31 to be Medical Biller’s Day for 2016. A portion of the proclamation from Alabama reads as follows: “WHEREAS, Medical Billers provide a much needed service to doctors and other healthcare providers and provide a vital segment of the health care industry; and “WHEREAS, […]
CMS Publishes Series of Chiropractic Billing Resources
The Centers for Medicare & Medicaid Services (CMS) has published three new MLN Matters special edition articles for chiropractors and other practitioners who submit claims to Medicare Administrative Contractors (MACs) for chiropractic services provided to Medicare beneficiaries. MLN Matters SE1601 is titled “Medicare Coverage for Chiropractic Services – Medical Record Documentation Requirements for Initial and […]
CMS Publishes Final Rule on Self-Identified Medicare Overpayments
The Centers for Medicare & Medicaid Services (CMS) has published a final rule on reporting and returning self-identified Medicare overpayments. The rule is specifically for Medicare parts A and B healthcare providers and suppliers. A separate final rule was published in May 2014 that addressed Medicare Parts C and D overpayments. The major provisions for […]
CMS Issues 2016 Annual Update for Clinical Laboratory Fee Schedule and Laboratory Services Subject to Reasonable Charge Payment
The Centers for Medicare & Medicaid Services (CMS) has issued a new change request (CR) that should be of interest to clinical diagnostic laboratories that submit claims to Medicare Administrative Contractors (MACs) for services provided to Medicare beneficiaries. CR 9465 provides instructions for the calendar year (CY) 2016 clinical laboratory fee schedule, mapping for new […]
PGM and ICANotes Publish Whitepaper on Outsourced Billing for Mental Health
PGM Billing, a leading provider of integrated physicians billing services, practice management and revenue cycle management services, and ICANotes, a comprehensive electronic healthcare records solution for psychiatry and behavioral health professionals, have published a whitepaper discussing the benefits of the PGM and ICANotes’ billing platform for mental health professionals. The whitepaper, titled “The Case for […]
Medicare Increases Payments for Incomplete Colonoscopies
The Centers for Medicare & Medicaid Services (CMS) has announced it is revising the method for calculating payment for incomplete colonoscopies billed with modifier -53. Effective January 1, 2016, the new payment rates will apply when modifier -53 (discontinued procedure) is appended to Current Procedural Terminology (CPT) codes 44388, 45378, G0105 and G0121. As CMS […]
Medicare Identifies Improper Payments Associated With Extracorporeal Shock Wave Lithotripsy
Medicare has disclosed the primary cause for improper payments associated with extracorporeal shock wave lithotripsy (ESWL). This is according to a recent issue of Medicare Quarterly Provider Compliance Newsletter (pdf), a newsletter from CMS developed to help providers understand the major findings identified by Medicare administrative contractors, recovery auditors and other governmental organizations, such as […]