Author finds fault with WPS policy. You might think that you could rely on the accuracy of a Medicare Administrative Contractor (MAC) policy, but apparently, you can’t.  First, I’d like to extend thanks to my colleague Sharon for sending me WPS’s deeply flawed split/shared evaluation and management (E&M) policy. If…
Case is centered around Level 2 and Level 3 E&M encounters. This past week, I received a call from an older physician who has been in practice for 46 years; for privacy purposes, we will refer to him in this piece as Dr. Purple. Before I tell you his story,…
AMA’s changes are complementary to the CMS proposed changes to this code set.  The Centers for Medicare & Medicaid Services (CMS) is moving quickly on its strategies for outpatient office evaluation and management (E&M) services, targeted for implementation in 2021, and the American Medical Association (AMA) is working hard to…
E&M changes, opioid crisis among issues profiled in the following forecast As the commentators who predicted that the Segway would revolutionize travel well know (you can read about that in Time), making predictions about how the world will change is challenging. When I storm-chase, I think of myself as a…
CMS recently released the final rule for the Medicare Physician Fee Schedule. Before I dive into the specifics of the recently released 2019 final rule for evaluation and management (E&M) services, allow me to quickly speak to three elements that the Centers for Medicare & Medicaid Services (CMS) has not…
THIS STORY HAS CORRECTED TO REFLECT THE NOV. 2 RELEASE OF THE FINAL FOR 2019 EDITOR’S NOTE: CMS on Thursday released the 2019 Medicare Physician Fee Schedule. For 2019 and 2020, we will see no changes to our outpatient, office-based evaluation and management (E&M) services, but things will change come…
Release by CMS caps months of debate by stakeholders Long awaited and hotly debated, the 2019 Medicare Physician Fee Schedule (MPFS) and Quality Payment Program (QPP) final rules have been on the minds of healthcare shareholders since late July, when the Centers for Medicare & Medicaid Services (CMS) released proposed rules…
CMS is encouraging the integration of healthcare providers so that their size is increased to have averaged payments represent a break-even or better. CMS (the Centers for Medicare & Medicaid Services) views payment from a national perspective on a statistically averaged basis. Individual providers such as physicians, clinics, hospitals, home…