Related Stories

How Health Plans Are Covering COVID-19 Testing and Treatment - 06/24/2020

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.


Portal to Apply for Medicaid and CHIP Relief Funds Open - 06/11/2020

The Department of Health and Human Services (HHS) has opened a portal for physicians who treat Medicaid and CHIP patients to apply for federal emergency assistance related to COVID-19.


Use “Time, MDM” for Medicare Telehealth Coding - 06/02/2020

When coding for Medicare telehealth visits, you can use either medical decisionmaking (MDM) or time as the basis for your selection of office/outpatient evaluation and management (E&M) levels of service, the Centers for Medicare & Medicaid Services has clarified.


Medicine Pushes Texas Medicaid to Help Save Primary Care - 05/08/2020

Leaders of the Texas Medical Association and four large primary care specialty societies on Wednesday painted for senior Medicaid officials the bleak fiscal picture of many physician practices, and requested immediate financial assistance.


Feds Approve Texas’ Request for COVID-19 Medicaid Waiver - 03/31/2020

The Centers for Medicare & Medicaid Services (CMS) on March 30 approved Texas’ request to waive certain Medicaid regulatory requirements to help physicians and other health care professionals more effectively respond to the COVID-19 pandemic.


AMA Creates CPT Code for Coronavirus Test - 03/17/2020

The American Medical Association has created a Current Procedural Terminology (CPT) code, 87635, to report laboratory testing services that diagnose the presence of the novel coronavirus.


Census Undercount Could Stifle Texas’ Health Services, Doctors Say - 03/11/2020

Texas physicians are urging patients to answer the upcoming U.S. Census to ensure the state won’t lose billions of dollars’ worth of health and human services funding – a loss that could harm the patients themselves.


Physicians Needed for Medicaid Managed Care Advisory Panel - 03/03/2020

March 13 is the new deadline to get your application to the Texas Health and Human Services Commission if you want to serve on its State Medicaid Managed Care Advisory Committee. The panel advises the commission on Medicaid managed care operations statewide.


Medicaid Grant Could Pay for Your HIE Connection - 02/12/2020

Have you or your practice been considering connecting your electronic health record (EHR) to a health information exchange (HIE), but keep getting hung up by the cost? Well, here’s some good news. Three public HIEs recently were awarded contracts for a Medicaid grant that could pay for you to connect to their exchanges.


Proposed Medicaid Rule Would Severely Restrict Services, Medicine Argues - 02/03/2020

A proposed federal rule that would restrict how states fund their share of Medicaid would cause serious cuts in services, particularly for children, pregnant women, the elderly, and the disabled. That is the message the Texas Medical Association and multiple state and specialty medical societies have delivered to the Centers for Medicare & Medicaid Services.


Federal Funding for Women’s Health Services in Texas Restored - 01/24/2020

Texas will again receive matching federal funds for women’s health services through a Medicaid 1115 waiver Gov. Greg Abbott announced Wednesday. Under the agreement, Texas will receive about $350 million from Washington over the next five years to cover the vast majority of costs for its Healthy Texas Women program.


Help Medicaid Patients Keep Appointments With Free Rides - 12/11/2019

If your Medicaid patient has trouble keeping his or her appointments with your office due to lack of transportation or gas money, be sure the patient knows how to seek help from Medicaid.


Far-Reaching Implications: The Ripple Effects of Texas' Uninsured Rate - 12/04/2019

Data compiled by the Texas Medical Association and other organizations, as well as physicians’ own anecdotal experiences, show how 5 million uninsured patients in Texas become 5 million dominoes. As they fall, so do countless others representing the health of Texas: The economy and well-being of entire communities. The classmates and friends of uninsured children. And yes, the physicians who deal with the burdens of treating uninsured patients in emergency rooms and providing uncompensated care.


Examine the Billing Cycle “Vitals” for Your Practice - 11/13/2019

The Texas Medical Association’s free webinar, What You Need to Know to Evaluate Your Billing Process, offers a step-by-step process and tools to assess your practice’s financial health and identify key areas for improvement. The webinar will show you how to use practice management reports to evaluate your staff’s productivity, your billing and collections processes, and even payer performance.


Timing for Annual Medicare Mammograms - 10/29/2019

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


Using Unlisted Codes for Workers' Comp Services - 10/29/2019

Using Unlisted Codes for Workers' Comp Services


Recertification Required for Healthy Texas Women Program - 10/28/2019

If you provide health care services through the Healthy Texas Women (HTW) program, or if you want to begin providing HTW services, the annual recertification period is just around the corner.


Practice e-Tips on Coding - 10/24/2019

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


Texas Continues to Lead Nation in Uninsured Adults and Kids - 09/30/2019

As of 2018, 11.2% of Texas children younger than 19 were uninsured, up from 10.7% in 2017, according to data the Census Bureau released last week. All told, Texas has led the nation in uninsured residents over the past two years, Census data show.


Tying Immigration to Medicaid Foolish, TMA President Says - 08/20/2019

The Trump Administration's new rule seeking to limit access to green cards for immigrants who receive Medicaid and other government benefits will discourage people from seeing their physicians, worsening medical problems and harming public health, says Texas Medical Association President David C. Fleeger, MD.


Payers Axe Consultation Codes - 08/07/2019

Both Cigna and UnitedHealthcare (UHC) have announced that starting in October, they will no longer pay for CPT consultation codes 99241-99245 – office consultations – and 99251-99255 – inpatient consultations. UHC’s policy change becomes effective Oct. 1, as outlined in its March bulletin. Cigna’s July newsletter says Cigna’s policy takes effect Oct. 19.


Get Dates of Service Right on Medicare Claims - 05/30/2019

When you a perform a Medicare service that is global, has both a professional and a technical component, or spans days or months, you need to know what date Medicare considers to be the official date of service when you file your claim. Here is some guidance from the Centers for Medicare & Medicaid Services (CMS) about coding and billing dates of service on professional claims.


Use Modifiers to Override Correct Coding Initiative Edits - 05/28/2019

Correct Coding Initiative Edits Now Free on Internet


Medicare X{EPSU} Modifiers Further Define Modifier 59 - 05/24/2019

The Centers for Medicare & Medicaid Services has established four new modifiers to define subsets of the commonly — but often mistakenly — used modifier 59.


Medicare Critical Care and Initial Hospital Services E and M Slated for Review - 05/17/2019

If you’ve been “probed and educated” twice by Novitas Solutions Inc. for high rate of claims errors regarding certain evaluation and management (E&M) services, you may receive more such review and education this summer.