CMS Publishes Revised Telehealth Services Fact Sheet

The Centers for Medicare & Medicaid Services (CMS) has recently published a revised fact sheet on telehealth services. The fact sheet provides information about originating sites; distant site practitioners; telehealth services; and billing and payment for professional services furnished via telehealth and the originating site facility fee. Here is some important background information on telehealth […]

OIG Report: $76 Million in Questionable Medicare Payments for Chiropractic Services

The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) recently analyzed Medicare paid claims for chiropractic services from 2013. A major finding: In 2013, $76 million in Medicare payments for chiropractic services were questionable, with Medicare inappropriately paying $21 million for chiropractic services that lacked a primary diagnosis covered […]

Register for Tomorrow’s Clinical Diagnostic Laboratory Test Payment System National Provider Call

The Centers for Medicare & Medicaid Services (CMS) is hosting a free MLN Connects National Provider Call that will discuss the Clinical Diagnostic Laboratory Test Payment System proposed rule on November 10 from 2:00-3:00 p.m. Eastern. The proposed rule — CMS-1621-P — would significantly revise the Medicare payment system for clinical diagnostic laboratory tests and […]

CMS Provides Clarification on the Use of Modifiers When Billing “Wrong Surgery on a Patient”

The Centers for Medicare and Medicaid Services (CMS) recently released a Medicare Learning Network podcast which was intended to clarify the correct use of certain HCPCS modifiers, specifically when billing for wrong surgery on a patient. CMS discussed the HCPCS modifier -PC (Wrong Surgery on Patient), which was established in CR6405 (pdf), along with two […]

American Chiropractic Association Publishes New PQRS Reporting Resources

The American Chiropractic Association (ACA) has published several new resources intended to help doctors of chiropractic (DCs) with proper implementation of Medicare’s Physician Quality Reporting System (PQRS). Eligible professionals who do not satisfactorily report data on quality measures for covered professional services will be subject to a PQRS negative payment adjustment (pdf) beginning in 2015. […]