The Centers for Medicare & Medicaid Services (CMS) has released a new, special MLN Matters article (pdf) on chronic care management (CCM) services frequently asked questions. Here are the 17 FAQs — and their answers provided by CMS — regarding billing CCM services to the physician fee schedule (PFS) under CPT code 99490. 1. CPT […]
Medicare Identifies Most Common Causes of Improper Payments for ESRD-Related Services
Medicare has determined that the majority of the improper payments for end stage renal disease (ESRD)-related services were due to insufficient documentation. This is according to a recent issue of Medicare Quarterly Provider Compliance Newsletter (pdf), a newsletter from CMS developed to help providers to avoid common billing errors and other erroneous activities when dealing […]
Understanding How to Code and Bill for Transcatheter Mitral Valve Repair
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 […]
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 […]