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3 / 19 / 2024

National Correct Coding Initiative (“NCCI”) Manual: Part One – Procedure to Procedure Edits

By Lori Carlin
In the introduction, we discussed the three (3) edit types that make up the National Correct Coding Initiative (“NCCI”). Probably the most familiar of those edits are the procedure...
3 / 14 / 2024

National Correct Coding Initiative (“NCCI”) Manual: The Ultimate Medicare Billing Toolkit

By Lori Carlin
One of the best resources we frequently recommend to providers is the National Correct Coding Initiative (“NCCI”) policy manual. It is like using a crystal ball to peer into...
2 / 15 / 2024

2024 Final Rule Part Four: Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs)

By Alysia Delozier
The Centers for Medicare and Medicaid Services (CMS) included some changes related to RHCs and FQHCs in the 2024 Final Rule. As referenced in our second article, CMS will...
2 / 8 / 2024

2024 Final Rule Part Three: Caregiver Training Services

Effective January 1, 2024, the Centers for Medicare and Medicaid Services (“CMS”) established an active payment status for CPT codes 96202 and 96203 (caregiver behavior management/modification training services) and...
2 / 1 / 2024

2024 Final Rule Part Two: Behavioral Health Services

By Alysia Delozier
The 2024 Medicare Physician Fee Schedule Final Rule revealed some great advancements in behavioral health services and how CMS will allow them to be billed.  We will highlight some...
1 / 25 / 2024

2024 Final Rule Part One: Split (or Shared) Evaluation and Management (“E/M”) Visits

According to the Centers for Medicare and Medicaid Services (“CMS”), Medicare Physician Fee Schedule Final Rule: “Split (or shared) E/M visits refer to visits provided in part by physicians...
1 / 18 / 2024

2024 Final Rule Summary of Changes

The 2024 Medicare Physician Fee Schedule Final Rule is packed with changes that will impact physician’s revenue. In this article, we provide an overview of some of those changes. Look...
12 / 20 / 2023

Social Determinants of Health (SDoH): What You Need to Know Moving into 2024!

By Amy Crenshaw-Pritchett
As we all know, until the release of the 2024 Physician Fee Schedule Final Rule on November 2, 2023; SDoH assessments were “voluntary” reporting measures for the Centers for...
10 / 19 / 2023

The How, Why, and Who: Capturing Social Determinants of Health (SDoH)

By Amy Crenshaw-Pritchett
The Centers for Medicare and Medicaid Services (CMS) issued the FY 2023 Final Rule, which required hospitals to report the new Inpatient Quality Reporting (IQR) program to submit two...
10 / 12 / 2023

Teaching Physician Basics

By Jessica Sullivan
Some facilities allow for a medical graduate training program where residents and medical students can participate in the care of patients under the direction of a licensed attending physician...