6 / 13 / 2024
By
Lori Carlin &
Angela Wood
Since 2020, telehealth services have seen many changes, but there were some significant changes to telehealth in the Centers for Medicare and Medicaid Services (“CMS”) 2024 Physician Fee Schedule...
5 / 30 / 2024
By
Amy Crenshaw-Pritchett
Introduction On April 10, 2024, The Centers for Medicare and Medicaid Services (CMS) released the proposed Inpatient Prospective Payment System (IPPS) for Fiscal Year (FY) 2025. Within the release...
5 / 23 / 2024
Pharmaceutical, medical device, and biotechnology companies (collectively life sciences companies or “LSCs”) utilize outside ‘experts’ (“Healthcare Professionals” and “Key Opinion Leaders”, collectively “HCPs/KOLs”) to provide a wide variety of...
5 / 16 / 2024
By
Amy Crenshaw-Pritchett
On April 1, 2024, the Centers for Medicare and Medicaid Services (“CMS”) finalized their Calendar Year (CY) 2025 rates for Medicare Advantage (“MA”) and Part D prescription drug programs....
4 / 25 / 2024
By
Kelly Conroy &
Zach Maher &
Daniela Yusufbekova
Every primary care physician (PCP) in the United States should be integrated into an accountable care model. The primary objective of accountable care models is to provide all participating...
4 / 23 / 2024
In January of 2021, the American Medical Association (AMA) released new evaluation and management (E/M) guidelines that simplified the documentation requirements for outpatient E/M services. On the heels...
4 / 23 / 2024
By
Lori Carlin &
Angela Wood &
Alysia Delozier
Recently, we have been getting questions about the new Healthcare Common Procedural Coding System (“HCPCS”) code G2211 (Visit complexity inherent to evaluation and management associated with medical care services...
4 / 17 / 2024
By
Lori Carlin &
Angela Wood
If you have questions about how to properly bill Medicare for bilateral procedures, the National Correct Coding Initiative (“NCCI”) policy manual has your answers. Starting on page 30 of...
4 / 3 / 2024
By
Lori Carlin &
Angela Wood
In this series of articles on the National Correct Coding Initiative (“NCCI”) Policy Manual, we have discussed procedure to procedure (“PTP”) edits and medically unlikely edits (“MUE”), but were...
3 / 28 / 2024
By
Kelly Conroy &
Daniela Yusufbekova &
Allison Carty
Introduction & Background Following the enactment of the Patient Protection and Affordable Care Act (PPACA) in March 2010, the healthcare industry has experienced a major shift in its reimbursement...