The Medicare Hospice Benefit proposed rule includes payment rates, wage index, and cap amount.  The Centers for Medicare & Medicaid Services (CMS) is proposing to increase hospice payments to $540 million in the 2020 fiscal year, an increase of 2.7 percent. CMS said the rate is based on the proposed…
April showers bring social determinants of health flowers The showers of April have brought a burst of blooms in the Social Determinants of Health (SDoH) reimbursement garden. First, the Centers of Medicare and Medicaid Services (CMS) released its 2020 rate sheet. As expected by the industry, Medicare Advantage and Part…
New strategy holds promise for future extensions of this technology.A medical practice can now bill and collect for a specific telehealth service without the strict rules of the originating sites being outside of a Metropolitan Statistical Area (MSA) or in a rural Health Professional Shortage Area (HSPA) located in a…
Confusion persists in understanding the definition of the two visits. We created a lot of buzz the past two weeks on our Talk Ten Tuesday broadcast an article on new versus established patient visits: so much, in fact, it was hard to keep up with all the email feedback, which…
CMS and ONC get serious about interoperability during HIMSS.During the HIMSS 19 conference in Orlando last week, the heads of the Office of the National Coordinator (ONC) for Health Information Technology and the Centers for Medicare & Medicaid Services (CMS) took extraordinary steps by discussing the content of two proposed…
A National Coverage Determination (NCD) will reimburse providers for diagnostic tests using sequencing.Today’s topic is DNA sequencing and its effect on society as a whole, on healthcare, and on Medicare. Sequencing is a laboratory procedure that maps the pattern of nucleotides in DNA. In 2003, sequencing an individual cost $2.7…
Not billing the APP service can result in serious revenue cycle errors. Many providers are still struggling with the non-physician practitioner (NPP) billing rules from the Centers for Medicare & Medicaid Services (CMS). Most facilities are now referring to NPPs as Advanced Practitioner Professionals or APPs. I get questions all…
The U.S. is in the middle of flu season this month and the opioid crisis appears unabated. There are several public health issues that are impacting the United States at the moment, and this article will focus on two of them: flu immunization and the opioid epidemic, in particular.   Have…
Interoperability is seen as the first step to using data for health improvement. I expect that 2019 will be the “Year of Interoperability”.  The Centers for Medicare & Medicaid Services (CMS), through its hospital and physician incentive programs, is asking providers to have their electronic health records (EHRs) capable of…
Coders can expect to confront new challenges, including new payment models and HIPAA changes. The new year brings new challenges for the healthcare industry. From new payment models to updates to the Health Insurance Portability and Accountability Act (HIPAA) to 21st Century Cures, hold on to your hats, because it…