The Centers for Medicare and Medicaid Services finalized changes to the 2024 Physician Fee Schedule – Medicare Shared Savings Program on November 2, 2023. The changes in the final rule aim to advance CMS’ value-based care strategy.  Here are some of the major highlights of the changes:

• Quality Measure Collection Types. CMS established a new collection type for ACOs called the Medicare Clinical Quality Measure (CQM) starting January 1, 2025. This addresses the concerns ACOs had with Electronic Clinical Quality Measures (eCQMs), which would have required ACOs to submit quality measures on ALL populations, not just Medicare, ...

Background

With increases in technology and breakthroughs in the healthcare field, new and innovative medical specialties and/or sub-specialties are gaining prominence.  Amongst those specialties is the field of interventional neuroradiology – a marriage of radiology, neurology, and neurosurgery.  As discussed in the following sections, we examine the origins and purpose of the specialty as well as key trends and compensation considerations as this field is seemingly here to stay.

What is Interventional Neuroradiology?

In recent years, hospitals have seen an increased use in Interventional Neuroradiology, also referred to as “INR”.  As defined by Columbia ...

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 (2) new measures (SDOH-1) and (SDOH-2).  The measures were voluntary in FY 2023; however, are required in FY 2024.

On September 6, 2023, CMS released the Improving the Collection of Social Determinants of Health (SDOH) Data with ICD-10-CM Z-Codes.  The data informatic was very “busy,” so Pinnacle is going to break down the information for you!

What Are Z-Codes?

• SDoH-related Z-Codes are located within categories Z55-Z65 in the ICD-10-CM diagnosis coding manual.
• Used to ...

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 (teaching physician). This allows the residents and medical students to further expand their medical knowledge and get real-world experience with their patients and colleagues.  Teaching physician services have specific documentation requirements, and it is important to understand these requirements to stay in compliance with CMS regulations.

Per CMS guidance and policy, “When billing Evaluation and Management (E/M) services for a teaching physician you must look for, at a ...

In many countries and regions of the world, access to valid, reliable, and comprehensive healthcare professional (“HCP”) compensation data can be a challenging task. Notwithstanding, in countries outside of the U.S. (“OUS”), determining FMV compensation for speakers, advisory board members, consultants, researchers, and others is crucial to maintaining compliance with global laws (e.g., FCPA, U.K. Bribery Act), country-specific laws (e.g., France, Portugal, others), and industry organizations (e.g., EFPIA, IFPMA, MedTech Europe, GMTA, etc.). Consequently, companies often utilize a range of informal sources of information to obtain what is erroneously represented as the FMV of HCP compensation. Typically, informal ...