Category Archives: Coding & Billing
Coding E/M Services – Part 1
Few things cause as much provider confusion – even frustration and angst – than medical coding. But coding is intricately linked to payment so the importance of doing it correctly has significant repercussions. The Centers for Medicare and Medicaid Services … Read Full Post
Did You Know…Medicare pays for Activities Related to Home Health?
In order for a home health agency to deliver physician-ordered home health services, the agency must prepare a Plan of Care (POC) for the patient that conveys the physician’s orders for the care. The POC must be signed by the … Read Full Post
Did You Know…Medicare pays for Alcohol Mis-Use Screening & Counseling?
We all understand that mis-use of alcohol can lead to significant issues, but not many providers know that CMS will pay them to conduct a 15-minute patient screening to identify any mis-use of alcohol and, if found, to deliver up … Read Full Post
Telehealth & MRA
There is much miscommunication regarding the use of telehealth services to report risk adjusted diagnoses. In the early days of COVID-19, CMS stated that it would pay for telehealth services that were conducted in an interactive format using both audio … Read Full Post
AHIP Summarizes Payor COVID-19 Policies
America’s Health Insurance Plans has helpful info on its website detailing COVID-19 coverage and payment changes for what appears to be every single health plan. This comprehensive list delves into waived cost-sharing, inpatient and outpatient coverage updates, and even available … Read Full Post
CMS Suspends Advance Payments to Part B Providers
As explained in the most recent Fact Sheet, CMS is suspending payments to Part B providers through its Advance Payment Program. This decision comes on the heels of a significant reinfusion of funds to provider relief efforts. The $175 billion … Read Full Post
Repayment Proposals for Advance Payments (AP) During COVID-19
As explained in a prior blog, CMS will grant providers advance payment of three-months of Medicare claims, with repayment due by the 120th day of issuance of payment. After that time, interest will attach to the unpaid balance and CMS … Read Full Post
CMS Issues Recommendations to Re-Open Health Care Systems in Areas with Low Incidence of COVID-19
On April 19, the Centers for Medicare & Medicaid Services issued new recommendations specifically targeted to communities that are in Phase 1 of the Guidelines for President Trump’s Opening Up America Again with low incidence or relatively low and stable … Read Full Post
CMS Expands Telehealth Coverage
**This blog was updated in June 2020. Click here to read the most current information. As a result of the COVID-19 public health emergency, the Centers for Medicare and Medicaid Services (CMS) expanded the provisions for coverage of telehealth (TH) … Read Full Post
Advance Payments (AP) During COVID-19
Many providers are feeling the financial pinch as a result of the business changes brought about by the COVID crisis. Chief among them is a disruption in claims payment from the Centers for Medicare and Medicaid Services (CMS) for services … Read Full Post