Better late than never: Stimulus bill salves pain of conversion factor cut, also delays G2211

January 7, 2021 | By Grant Huang, CPC, CPMA The 2021 Physician Fee Schedule (PFS) had included the largest one-year reduction to the Medicare conversion factor (CF) in more than 20 years, but it won’t actually take effect because the CF is being increased as a result of provisions in the recently passed stimulus legislation.…

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Changes to Stark May Require Tweaks to the Physician Compensation Formula

  January 8, 2021 | By David Glaser In early December, the Centers for Medicare and Medicaid Services (CMS) issued new rules that dramatically revise the Physician Self-Referral Law, commonly called the “Stark law” after Pete Stark, the Congressman credited with introducing it. While many of the changes loosen the law’s restrictions, focused particularly on…

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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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