Coverage

Analyze the potential impact of CMS’ major proposed changes to physician reimbursement.

Ensure your organization is in compliance with CMS’ latest requirements.

CMS is proposing a 4% decrease to the Medicare conversion factor, permanent expansion of telehealth coverage for some mental health services, and new timelines for Appropriate Use Criteria (AUC) reporting, according to the 2022 Medicare Physician Fee Schedule (MPFS) proposed rule.

Reach the next level of revenue integrity

Brush up on the most recent changes to Medicare’s prior authorization requirements and their operational impact.

CMS boosted Medicare payment for COVID-19 vaccines administered in the patient’s home to $75 per dose, the agency announced June 9. Prior to June 9, Medicare paid $40 per dose for COVID-19 vaccines administered in the patient’s home.

Jugna J. Shah, MPH, CHRI, discusses why innovative therapies and technologies call for innovations in existing coding, billing, and reimbursement models.

Ronald Hirsch, MD, FACP, CHCQM, CHRI, examines recent changes to commercial payer prior authorization requirements and how it affects revenue integrity.

Two CPT^® codes are temporarily suspended from the prior authorization program for hospital outpatient departments, CMS announced.

CMS released an updated list of Medicare telehealth services while cautioning organizations to pay close attention to telehealth billing rules.