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Aetna Set to Pay Medicare Advantage G2211 Claims - 03/27/2024

The list of health plans providing payment for Medicare’s new add-on “G” code continues to grow with Aetna as the latest insurer to cover G2211 for Medicare Advantage claims Aetna confirmed with Texas Medical Association coding experts that its Medicare Advantage claims platform was updated in March to allow payment for the code, used to document the coordination of care for patients with complex or serious conditions. For now, the plan’s policy is only accessible through a physician’s Aetna portal.

Quality of Life: Pay-for-Quality Programs Increasingly Address Nonmedical Drivers of Health - 03/15/2024

Insurance payers seldom give physicians incentives to address nonmedical drivers of health, especially in traditional fee-for-service payer contracts. Those incentives remain rare even in pay-for-quality programs that emphasize value-based care, but they are gaining traction.

TMA Develops New AI Education - 03/10/2024

Responding to significant interest from members after a 2023 standing-room-only TexMed event, the Texas Medical Association has developed a free webinar for members to learn how to integrate augmented or artificial intelligence technology, including ChatGPT, into patient care.

Coding Changes in Fee Schedule Promote More Accurate Payment for Complex Visits - 03/05/2024

The 2024 Medicare physician fee schedule allows physicians to list G2211 in addition to codes used in office or outpatient visits for new or established patients (i.e., 99202-99215). Physicians also can use it for telehealth visits.

Find Other CME - 02/29/2024

Check out other CME offerings from around the state.

Novitas Makes Mass Payment Adjustment for Telehealth Claims - 02/27/2024

Thanks to the vigilance of the Texas Medical Association’s payment specialists, Medicare administrative contractor Novitas Solutions updated its system to ensure all claims billed with place of service (POS) code 10 will be paid correctly.

May Owen, MD, Outreach Program Funds Women Physician Programs, Activities - 02/26/2024

To partner with small and mid-sized county medical societies to provide women physicians with programming and activities at the local level, the Texas Medical Association’s Women Physicians Section has established the May Owen, MD, Outreach Program.

Practice e-Tips on Coding - 02/20/2024

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

TexMed 2024 CME Submissions Are Open - 01/11/2024

Have an educational topic in mind to be considered for TexMed 2024, taking place at the Omni Dallas, May 2-4, 2024?

Physicians’ DEA Registration Now Requires Training on Substance Use Disorder - 01/03/2024

Physicians who must register or renew their registration for a Drug Enforcement Administration license will face a new requirement as of June 27: To register, they will have attest to taking a one-time, eight-hour training on how to treat patients with opioid or other substance use disorders.

Your Billing and Collections Checklist for 2024 - 12/19/2023

TMA’s Reimbursement Services staff work year-round with physicians and health plans to help make sure you get paid correctly and on time. They’ve put together a list of practical actions you can take at the start of 2024 to keep your billing and collections on track throughout the year.

Add-On Payment Code for Complex Visits to Start in 2024 - 12/08/2023

Beginning in January, physicians will be able to receive more accurate payment for complex visits with Medicare add-on code G2211. But the Texas Medical Association continues to push for additional guidance as confusion over the code’s use persists.

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.

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.

New CME! Talk to Parents About Vaccine-Preventable Diseases - 09/06/2023

Talking to parents about vaccines can be challenging, especially with the anti-vaccine movement, and the COVID-19 pandemic has caused a decline in childhood vaccinations across the country. That’s why the Texas Medical Association has created a CME course to better prepare you for these conversations.

Business of Medicine Conference Offers More – And More Practical – Educational Programming - 08/31/2023

With an eye toward equipping physicians to navigate the modern medical practice landscape, the Texas Medical Association’s inaugural Business of Medicine conference in October offers more than triple the amount of educational content compared with last year’s counterpart, Fall Conference.

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.

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.

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.

Payers Axe Consultation Codes - 07/25/2023

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.

E&M Coding — Are You Under, Over, or on Target? - 07/20/2023

E&M Coding — Are You Under,Over,or on Target?

Document Time for Psychotherapy Services - 07/20/2023

Year-old changes in psychiatry and psychotherapy CPT codes are still tripping up physicians. According to Medicare, distinguishing between evaluation and management services and psychotherapy is the key.

Ask TMA Experts About Grassroots Virtual Advocacy - 07/17/2023

Ready to take the plunge into grassroots advocacy at the legislature but still not confident about what to do and how to do it? The Texas Medical Association’s Feb. 25 Ask the Expert session is your opportunity to ask questions about tactics, tools, messaging, and more, and how it all works in a virtual environment.

Continuing Medical Education Programs - 07/13/2023

The Physician Health and Wellness (PHW) Committee offers several ongoing courses on a wide range of topics to educate physicians, TMA Alliance members, hospital administrators, and others. PHW activities encourage physicians to promote and maintain their health and wellness, which fosters healthy lifestyles in patients.