November Bulletin – UnitedHealthcare’s COVID-19 Response – Update

  UnitedHealthcare’s COVID-19 Response – Update   Telehealth Throughout the public health emergency (currently set to end on January 20, 2021), UHC is extending the cost share waiver for COVID-19 in-network telehealth services. UHC will also waive cost share for COVID-19 treatment until December 31, 2020. For out-of-network services, the cost share for COVID-19 testing […]

Top Challenges Facing Labs Today: 4 Key Takeaways From Lab Institute 2017

Representatives of Physicians Group Management (PGM Billing) recently returned from attending and exhibiting at Lab Institute 2017. This meeting, hosted by G2 Intelligence, brings together professionals from throughout the lab industry for three days of education and networking. In this ever-changing, ever-evolving healthcare environment, many sessions focused on the top challenges facing laboratories. Here are […]

New -59 Modifier Subsets Go Into Effect

Back in September, we told you about the Centers for Medicare & Medicaid Services establishing new HCPCS modifiers to define specific subsets of the -59 modifier. These new modifiers went into effect on January 1, and had an implementation date of January 5. To summarize: The introduction of the subset modifiers is intended to reduce […]

OIG’s 2015 Planned Areas of Focus Include Ambulatory Surgery Centers, Anesthesia and Chiropractic Services

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) released its Work Plan for Fiscal Year 2015 (pdf) in late October. The Work Plan summarizes planned areas of focus for investigation and enforcement activities that OIG plans to pursue with respect to HHS programs and operations during the current fiscal year […]

Highlights of Policy and Payment Changes to the Medicare Physician Fee Schedule for 2015

The Centers for Medicare & Medicaid Services (CMS) recently issued its final rule that updates payment policies and rates for services furnished under the Medicare Physician Fee Schedule (PFS) in 2015. Here are some of the highlights of the policy and payment changes for services furnished under the PFS. Screening and diagnostic digital mammography. Until […]