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 […]

CMS Developing Oncology Bundled Payment Model

The Centers for Medicare & Medicaid Services has announced it is developing a new bundled payment model for oncology. The Oncology Care Model (OCM) is a new payment model for physician practices administering chemotherapy. Under OCM, practices will enter into payment arrangements that include financial and performance accountability for episodes of care surrounding chemotherapy administration […]

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 […]