Capturing HCCs in a Changing World

  Amy C. Pritchett, CCS, CRC, CPA-RA, CPC, CPMA, CPCO, CDEI, CDEO, CDEC, CANPC, CASCC, CMPM Manager, HCC Coding/Audit & Education Services, Pinnacle Enterprise Risk Consulting Services AAPC Fellow |Approved Instructor |ICD-10-CM/PCS Trainer On March 31, 2023, the Centers for Medicare and Medicaid Services (CMS) released the CY 2024 Medicare Advantage (MA) Capitation Rates along…

Understanding Chronic and Principal Care Management Services (CCM vs. PCM)

  September 29, 2023 | By Grant Huang, CPMA, CPC If you’ve never heard of principal care management (PCM) or chronic care management (CCM) services before, you’re not alone. Medicare introduced these new benefits for Part B beneficiaries in 2021 and 2022, respectively, but the agency’s own utilization data shows that adoption has been fairly…

Recreating the Structure

  September 22, 2023 | By Shannon DeConda, CPC, CEMC, CEMA, CPMA, CRTT Let’s get uncomfortably honest. With continued reimbursement cuts, like this year’s $9-12k per provider E/M cut, organizations cannot sustain 100% coding validation. Now, let’s get brutally honest. This is compounded by a lack of truly skilled and knowledgeable coders looking to fill the…