AMA Adds Connected Health CPT Codes, Pushes for Medicare Payment

Published: Tue, 09/11/18

The American Medical Association (AMA) updated the Current Procedural Terminology (CPT) code set in 2019 to include new codes for connected health services in an effort to encourage CMS to pay for the services. The 2019 CPT code set contains 335 code changes that will go into effect for medical billing and coding on...

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CMS’s Proposed E&M Coding Changes and the Rest of the Story

The 2019 proposed Medicare Physician Fee Schedule has clearly articulated the Centers for Medicare & Medicaid (CMS) goal of “patients over paperwork.” I think almost everyone agrees with that goal. Most physicians applaud any improvement in lessening the documentation burden and “note bloat.” The concern with the proposed rule is that in many ways, increased burden for physicians and their agents and representatives will ensue.

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CMS Proposes 50 Percent Reduction in Claims Submitted with Modifier 25

By now I am sure that everyone is well aware that the Centers for Medicare & Medicaid Services (CMS) has proposed modifications to the reimbursement model for the outpatient/ office evaluation and management (E&M) code sets, as well as the anticipated documentation relaxation accompanying the proposal. These two portions of the proposed changes are getting much

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PLANNING AHEAD: Reasons Why Medical Bills Are Out of Control

If you ever wondered why you might receive a blockbuster medical bill even if you have health insurance, the reporting of Kaiser Health News (KHN) can help. KHN, a nonprofit news service that reports on how the health care system works, is editorially independent of another well-known nonprofit, the Kaiser Family Foundation, and not affiliated with the health insurance company, Kaiser Permanente. It can be accessed online at...

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Proposed 2019 Physician Fee Schedule Threatens Single Fee E and M Payment Rates

Proposed rule will cut by 50% claims submitted with modifier 25. In what is being reported as the biggest change of its kind in more than two decades, the Centers for Medicare & Medicaid Services (CMS) plans to redefine the documentation requirements for evaluation and management (E&M) coding in 2019, along with flattening payments for new and established patient office visits to a single pay system.

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