Auditing Critical Care Services
January 15, 2021 | By Stephanie Allard, CPC, CEMA, RHIT CMS defines critical care as “the direct delivery by a physician(s) of medical care for a critically ill or…
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…
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…
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…
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…
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…
COVID-19: Resident Services Under the Medicare Primary Exception
November 27, 2020 | By Grant Huang, CPC, CPMA Auditing evaluation and management (E/M) services furnished by resident physicians under the Medicare Primary Exception (PCE) already required a firm…
How Relative Value Units Are Calculated
October 30, 2020 | By Edward Townley, Founder, Cogent9 Consulting We use relative value units (RVUs) in many aspects of our practices. Some physician compensation arrangements are based on…
Prepare Now for Gray Areas in 2021 E/M Rules
October 23, 2020 | By Grant Huang, CPC, CPMA It’s not even 2021 yet, but gray areas have already surfaced in the 2021 E/M documentation guidelines, as more and…
Understanding MDM in 2021 – Part 1
September 4, 2020 | By Brenda Edwards, CPC, CDEO, CPB, CPC-I, CEMC, CRC, CMRS, CMCS Is anybody not aware of the Evaluation and Management (E/M) changes coming in January 2021?…