Medicare

Medicare Toolkit Social Media Graphics - 11/15/2023

Once again, physicians face cuts to their Medicare payments in 2024, stinging practices trying to stay viable and care for the most vulnerable patients. The Texas Medical Association strongly urges Congress to find permanent, sensible solutions to the Medicare physician payment system.  

CMS Releases 2024 Medicare Advantage and Part D Plan Ratings - 11/13/2023

Medicare patients and the physicians who care for them now have more information to guide their choice of plan in 2024.

Final 2024 Medicare Fee Schedule Solidifies Pay Cuts, Heightens Calls for Reform - 11/13/2023

Now that it’s been finalized, the 2024 Medicare physician fee schedule has solidified yet another pay cut, set for Jan. 1, 2024, underscoring calls for Medicare physician payment reform from physician advocates and lawmakers who’ve recently convened in federal hearings on the topic.

Medicare Cuts Forcing Doctors Out - 11/08/2023

A 3.37% cut in Medicare physician pay is scheduled to hit on Jan. 1, 2024. That’s on top of the 2% cut that took effect earlier this year and other compounding cuts over the years. In total, inflation-adjusted physician Medicare pay has fallen 26% since 2001. Medicare physician pay cuts are forcing some physicians out of the program.

Medicare Premiums, Deductibles to Increase in 2024 - 10/27/2023

Medicare patients will be paying more for their coverage in 2024, which will impact how much co-pay practices collect.

CMS to Implement Street Medicine Code - 10/25/2023

Following advocacy from the Texas Medical Association and medical student members, the Centers for Medicare & Medicaid Services (CMS) created a place of service code for street medicine, making it possible for physicians to get paid for services provided to people who are currently unhoused effective Oct. 1.

Government Shutdown Could Delay Medicare Claims Payments, Reform - 10/18/2023

The looming federal government shutdown would have ramifications for physicians across the country as well as for desperately needed Medicare physician payment reform.

First-Ever MIPS Penalties Surface; Share Your Story With TMA - 10/16/2023

Given recent changes to Medicare’s Merit-Based Incentive Payment System (MIPS) and an ongoing push for Medicare physician payment reform, the Texas Medical Association encourages member physicians who participate in MIPS to closely review their final scores for the 2022 performance year.

Code Carefully for Bilateral Procedures - 10/04/2023

Coding for bilateral procedures can be confusing. Many payers accept CPT modifier 50 as an indicator of a bilateral procedure, but they differ in how they apply it to their coding and payment policies.

Medicare Fee Schedule Proposal Remains “Highly Flawed,” Underscores Need for Reform - 09/28/2023

The proposed 2024 Medicare physician fee schedule came as no surprise, following earlier iterations that deepen physician pay cuts and increase complexities associated with the Merit-Based Incentive Payment System (MIPS) – prompting organized medicine to ramp up its call for reform that would break this cycle.

Reminder: Revalidate Your Medicare and Medicaid Enrollment - 09/25/2023

Starting Nov. 1, physicians must use a revised Medicare enrollment application. On the Medicaid front, physicians who were due to re-up their enrollment during the COVID-19 public health emergency get a grace period to complete this requirement, but all physicians must review and update their practice addresses. Read more.

Medicare Advantage Audits Expected to Rise in Face of Increased Federal Scrutiny - 09/20/2023

Based on a new rule and in response to heightened scrutiny, Medicare Advantage plans – and the physician practices that care for patients enrolled in them – should expect an increase in the number of audits related to such risk-sharing contracts.

Medicine, Congressional Leaders Strategize to Expedite Medicare Physician Pay Reform - 09/17/2023

TMA and other physician and congressional leaders from around the country convened an advocacy summit to build momentum for legislation to finally help Medicare payments keep pace with inflation. With nearly 40 co-sponsors signed on, and another pay cut on the way, medicine and lawmakers urged physicians to ramp up their advocacy now.

How to Identify Dual-Eligible Patients - 08/23/2023

The Centers for Medicare & Medicaid Services has been working to rein improper billing of Qualified Medicare Beneficiary program-enrolled patients, who have both Medicare and Medicaid coverage. You can verify patient status in several ways.  

TMA to Feds: Some Proposed QPP Changes “Costly and Wasteful” - 08/23/2023

TMA letter praises the Centers for Medicare & Medicaid Services for its commitment to deregulation and outlining TMA's concerns about the proposed changes and recommendations for how to improve the QPP.

Practice e-Tips on Medicare - 08/21/2023

Get practice tips on all things Medicare. Learn what Medicare requires for enrollment, participation, billing, claims, coding, documentation, and more.

Billing Errors to Avoid: Pulmonary, Mohs Procedures - 08/21/2023

Medicare audits have revealed recurring errors in billing for pulmonary procedures and Mohs surgery. Here are some guidelines for correct billing.

Is Medicare’s Chronic Care Management Program for You? - 08/21/2023

Interested in the possibility of getting paid as much as $75,000, or even more, for something you already more or less do? Medicare now pays separately for chronic care management services. To help you decide if this new opportunity is right for your practice, TMA created a new online resource center.

Heads Ups: New and Notable From Medicare - 08/21/2023

Here are some Medicare updates to keep on your radar for 2017 and into 2019. Most notable: The Centers for Medicare & Medicaid Services (CMS) has made Medicare Access and CHIP Reauthorization Act (MACRA) reporting easy for 2017 so you won’t earn a penalty.

All Things Medicare - 08/21/2023

Need help with Medicare payment issues or with Medicare coding? Do you need information about Medicare enrollment or about participation options? Or are you looking for information about the future of Medicare – what about the payment update, new provisions in the federal Affordable Care Act, new bonuses or new compliance requirements?

Medicare Coding Errors to Avoid: Add-on, Place of Service, and Modifiers - 08/21/2023

Medicare audits have revealed recurring errors in billing with add-on and place-of-service codes as well as claims that appear to be duplicate because they lack an appropriate modifier. Here are some guidelines for correct billing.

Ways to Avoid a Medicare Appeal - 08/21/2023

How much time does your practice waste correcting Medicare claims, or appealing denied claims? Novitas Solutions says it receives almost 2 million requests annually just to correct minor claims errors or omissions. Here are top ways to avoid a correction or appeal.

Medicare Payment - 08/21/2023

What do you need to know about payment from Medicare? Use the links below to get the fee schedules, find out what services are covered, and more.

Use Modifiers to Override Correct Coding Initiative Edits - 08/21/2023

Correct Coding Initiative Edits Now Free on Internet

More Medicare Payment Updates for 2015 - 08/21/2023

Find out changes affecting pneumococcal vaccine, preventive and screening services, and new waived tests, plus a revalidation tip and how to learn more about Physician Compare.