Medicare

AMA Report: Medicare Physician Spending Fell Sharply During First Half of 2020 - 05/07/2021

Thanks to the early shutting down and shutting in prompted by COVID-19, spending on Medicare physician services fell as much as 57% short of expected levels during April 2020, and nearly one-fifth below expected spending over the first six months of that year.


Medicare 2% Payment Cut Suspended Through 2021 - 04/15/2021

President Joseph Biden this week extended the suspension of the Medicare sequestration, the federal government’s 2% across-the-board payment cut, through the end of the year.


Medicare as Secondary Payer - 04/08/2021

Medicare as secondary payer: Submit the primary EOB with paper claims but not with electronic claims.


Medicare Claim Errors: The Easy and the Common - 03/31/2021

Filing your Medicare claims correctly the right way every time saves time and money. Fortunately, correcting a simple mistake on a Medicare claim is easy. However you might need to invest in training if you commonly make more significant errors.


Why, What, and Who Keys to Recoupment-Proof Documentation - 03/30/2021

The lack of a signature on specific portions of an otherwise complete documentation is enough to warrant a Medicare payment recoupment. Here’s what the Centers for Medicare & Medicaid Services found in three Comprehensive Error Rate Testing reviews.


Novitas Requires Certain Forms for Paper Documentation - 03/30/2021

Novitas Solutions will return faxed or mailed documentation that is not submitted with certain approved Novitas forms.


Use Modifier AT With Tetanus Vaccine - 03/24/2021

For Medicare claims, to report the tetanus vaccine administered for  treating an injury or direct exposure to a disease or condition, append modifier AT to the code for the vaccine.


Submit 2020 Data Now to Avoid Medicare Pay Cut - 03/23/2021

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.


Review Your Physician Compare Data Now - 03/23/2021

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


Use Transitional Care Management CPT Codes - 03/18/2021

Two new CPT codes for transitional care management services are in effect, and Medicare accepts them. But read the Medicare rules carefully because they vary from the CPT guide.


Practice e-Tips on Medicare - 03/17/2021

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


More Medicare Telemedicine E&M Visits Eligible for Payment, CMS Says - 03/17/2021

Practices will be able to bill for audio-only telephone evaluation and management (E&M) visits during the same month as chronic care management (CCM) visits throughout the COVID-19 public health emergency, the Centers for Medicare & Medicaid Service (CMS) has announced.


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.


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.


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.


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.