What You Need to Know About Prolonged Services in 2021

  December 25, 2020 | By By Grant Huang, CPC, CPMA The New Year is nearly upon us and with it, implementation of the much-talked-about 2021 E/M guidelines for office/outpatient codes 99202-99215. These guidelines include completely revamping how time works for selecting code levels, which in turn has resulted in brand new rules for prolonged…

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After the Fire: Consideration of Risk-Based Contracts Post-COVID-19

  December 18, 2020 | By Paul Spencer, CPC, COC “Risk adjustment,” as defined by CMS, is a method by which Medicare Advantage plans are compensated for demonstrating that the Medicare patients they cover under Part C plans are sicker than those covered under traditional Medicare or other plans. Increasingly, when I speak to practices,…

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Finally: CMS releases 2021 final rule; no major surprises seen

  December 15, 2020 | By By Grant Huang, CPC, CPMA At long last, CMS has published its Medicare Physician Fee Schedule (PFS) final rule, and while some of the provisions will be widely felt across many specialties, there are no major or unexpected deviations from the proposed rule. The agency typically releases the PFS…

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Performing a Gap Analysis

December 4, 2020 | By Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC Last month, Paul Spencer, Senior Compliance Consultant of DoctorsManagement (DM) and I had the privilege of presenting to NAMAS members a course on performing a “gap” analysis in order to build a corporate compliance program that works in practice and is…

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