2024年11月8日 · Medicare reinstates certain pre-pandemic telehealth policies. COVID-19 public health emergency waivers that applied to Medicare Part B policies for The 2025 PFS final rule is the final word for telehealth services effective Jan. 1, 2025, unless Congress acts.

2025年1月15日 · Rulemaking and lawmaking keep telemedicine a viable solution for the masses, for now. Now that the dust has settled on the American Relief Act, 2025, Medicare policy for telehealth services is extended through March 31, but then what?

2023年12月21日 · Based on the current version of Medicare Claims Processing Manual 100-04 Chapter 12 Physicians/Nonphysician Practitioners section 20.4.3 Assistant-at Surgery-Services indicates that Medicare only covers assistant-at-surgery services to be provided by a physician, physicians assistant (PA), nurse practitioners (NP) and clinical nurse specialists (CNS).

INTRODUCTION The 2025 Medicare Physician Fee Schedule (PFS) Final Rule introduces significant changes that directly impact reimbursement, telehealth services, care delivery models, and compliance requirements.

2015年8月21日 · It’s best practice to periodically check your explanation of benefits carefully for claims with add-on codes to be sure the payer is reimbursing you the entire fee schedule rate for the billed procedures or services. If you find a payer reducing the fees for your add-on codes, be sure to appeal the claims.

Reimbursement for procedures and services performed by providers is made by commercial payers such as Aetna, United Healthcare, or federal intermediaries acting on behalf of healthcare programs.

Medical coding and billing are essential components of the healthcare industry, which help to ensure that healthcare providers receive proper reimbursement for their services while also keeping track of important patient data.

2025年2月3日 · Although G2211 was added in 2021, Medicare Part B didn’t begin reimbursing it until Jan. 1, 2024. Many Medicare Advantage plans have also approved coverage; however, coverage varies depending on the specific plan. Medicaid and commercial payers are not required to pay for services associated with G2211.

2024年5月15日 · An essential point that many providers may overlook is that the SDOH risk assessment is not a screening; it is “intended to be used when a practitioner has reason to believe there are unmet SDOH needs that are interfering with the practitioner’s diagnosis and treatment of a condition or illness,” CMS clarifies in the final rule.

2024年1月2日 · Don’t be afraid to bill this service. CMS has acknowledged that appropriately reimbursing providers for their expertise and cognitive work has been lacking for years. In fact, CMS assumes 38 percent of all E/M services in 2024 will be billed with G2211. The national payment rate for this add-on code is $16.04.