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Practice e-Tips on Medicare - 02/26/2021

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


Practice e-Tips on Coding - 02/26/2021

Get practice tips on all things coding. Learn about coding methods, correct coding, resources, coding related to Workers' Comp and more.


Low-Level Code May Have High Misuse - 02/26/2021

It’s been called the “nurse visit” code, and also “the most abused code in the CPT book.” Do you use 99211 correctly?


All MIPS-Eligible Physicians to Qualify for Hardship Exemption, CMS Says - 02/26/2021

Due to the continuing COVID-19 pandemic, the Centers for Medicaid & Medicare Services (CMS) is automatically applying the extreme and uncontrollable circumstances policy under the Merit-Based Incentive Payment System (MIPS) to ALL MIPS eligible clinicians regardless of whether those clinicians have submitted data for the 2020 performance period.


Submit 2020 Data Now to Avoid Medicare Pay Cut - 02/12/2021

If you participated in Medicare’s Quality Payment Program (QPP) under the Merit-Based Incentive Payment System (MIPS), the deadline to submit all data through the Centers for Medicare & Medicaid Services (CMS) portal has been extended one day to April 1. The deadline had been March 31.


List Cost on Medicare Radiopharma Claims - 02/05/2021

When billing Medicare for radiopharmaceutical procedure codes, you must list the total acquisition cost on the claim.


CMS Open Payments Registration Under Way - 02/04/2021

Registration is now open for the Centers for Medicare & Medicaid Services’ (CMS) Open Payments Program, which requires CMS to publicly report data on items of value given annually to physicians and teaching hospitals.


Medicare Payments For January Withheld - 02/02/2021

Novitas Solutions, the Medicare administrative contractor for Texas, has held physician Medicare payments for services rendered in January 2021 to comply with changes to federal laws, the Texas Medical Association has confirmed.


Review Your Physician Compare Data Now - 01/29/2021

The Centers for Medicare & Medicaid Services (CMS) recently opened its Doctors and Clinicians Preview Period, which allows you to check out your 2019 QPP performance data before its reported on Medicare Care Compare and in the Provider Data Catalog (PDC). CMS will close the preview period at 7 pm (CT) March 25.


Medicare Freezes Thresholds for MIPS Exemption - 01/22/2021

If you’re in a Qualifying Alternative Payment Model (APM) in Medicare’s Quality Payment Program (QPP), or you’re considering making the jump, take note: The thresholds for participating this year are now the same as in 2020 thanks to recent federal law.


The COVID-19 Relief Bill: What It Means For Medicare Payments - 01/11/2021

When Congress passed the omnibus spending and COVID-19 relief bill at the tail end of 2020, it carried important implications for physicians operating under this year’s Medicare physician fee schedule, including some changes that will positively affect doctors’ bottom line.


Medicare 2% Payment Cut Suspended Through March - 01/04/2021

Medicare sequestration, the federal government’s 2% across-the-board payment cut, will be suspended until March 31, because of the COVID-19 pandemic, officials said.


Take Action: Tell Federal Lawmakers to Stop Medicare Payment Cuts - 12/10/2020

TMA urges you to tell your federal lawmakers to support HR 8702, also known as the “Holding Providers Harmless from Medicare Cuts During COVID-19 Act,” which would freeze Medicare Part B payments at 2020 rates for two years.


CMS Finalizes Cut to Many Physician Payments, Adds Telehealth Codes in 2021 Fee Schedule - 12/04/2020

Medicare has finalized its 2021 physician fee schedule, resulting in payment cuts to many physicians due to the much-maligned budget neutrality requirements the Texas Medical Association has advocated against.


Deadline Extended: Apply for a MIPS Reporting Exemption - 12/02/2020

Did your practice face an unusual extreme hardship this year, such as financial or staffing difficulties related to COVID-19? If so, you could qualify for an exception to the Merit-Based Incentive Payment System (MIPS) reporting requirements for the 2020 performance year. The application deadline has been extended to Feb. 1, 2021. The previous deadline was Dec. 31, 2020.


Timing for Annual Medicare Mammograms - 11/20/2020

Medicare counts 11 full months after the month in which the patient received her screening


CMS Relaxes Lookback Period for Medicare Overpayments - 11/20/2020

The Centers for Medicare & Medicaid Services (CMS) has spoken, finalizing a controversial rule and relaxing the lookback period physicians must adhere to when returning Medicare overpayments. In 2012, CMS proposed requiring physicians to return Medicare overpayments going back 10 years. The agency announced last week the required lookback period will be six years.


TMA Questions QPP Data Showing Most Clinicians Will Receive Medicare Bonus in 2021 - 11/05/2020

The Centers for Medicare & Medicaid Services (CMS) has released preliminary data for the 2019 Medicare Quality Payment Program (QPP), which shows more than 95% of participating clinicians earned an incentive payment that they’ll see next year. However, Texas Medical Association experts are skeptical of the preliminary data.


CMS Announces Plans to Cover COVID-19 Vaccine - 10/29/2020

The Centers for Medicare & Medicaid Services (CMS) has released a rule to make COVID-19 vaccines available at no cost to Medicare, Medicaid, and CHIP patients.


Support Medicare Payment Parity for Another Year, TMA Tells Lawmakers - 10/26/2020

TMA is calling for passage of a bill that would require at least a one-year waiver of budget neutrality adjustments, which were part of the Centers for Medicare & Medicaid Services’ (CMS) proposed 2021 Medicare physician fee schedule, released in August.


AMA Creates CPT Codes for Combination COVID-19/Flu Tests - 10/15/2020

The American Medical Association (AMA) has created two new Current Procedural Terminology (CPT) codes for multi-virus testing to detect COVID-19 and influenza.


TMA Balks at Proposed Medicare Payment Cut, More Changes to QPP During Pandemic - 10/12/2020

Physicians who renew their medical licenses after Sept. 1, 2020, are required to take one hour of CME that addresses human trafficking. TMA has now published its own CME course to educate physicians on how to identify, treat, and respond to people who are at risk or who have been trafficked.


How Health Plans Are Covering COVID-19 Testing and Treatment - 10/09/2020

Many health insurers in Texas are waiving patient costs associated with COVID-19. Last week in a news release, Gov. Greg Abbott and the Texas Department of Insurance asked insurers and HMOs to cover testing consistent with Centers for Disease Control and Prevention guidance, and telemedicine visits.


Last Chance to Start Certain 2020 MIPS Reporting Tomorrow - 10/02/2020

If you participate in Medicare’s Quality Payment Program (QPP) under the Merit-Based Incentive Payment System (MIPS), you will have to report on the required measures – Promoting Interoperability and Improvement Activities – starting Saturday, Oct. 3.


TMA Opposes Bill Defining Clinical Psychologists as Physicians in Medicare - 09/28/2020

A broad swath of organized medicine, including the Texas Medical Association, is asking congressional leadership to oppose a bill that legally would consider clinical psychologists to be physicians within Medicare, saying it “inappropriately” expands psychologists’ scope of practice.