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Thursday Apr 19, 2018

How to know when to bill for both preventive and added services

When a patient brings an additional complaint to a preventive visit, how do you know whether it qualifies as a separate service and how should you code and bill for it?

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Posted at 08:00AM Apr 19, 2018 by David Twiddy | Comments [0]

Wednesday Apr 04, 2018

More Medicare money potentially headed to you

The Bipartisan Budget Act of 2018 is requiring Medicare administrative contractors to reprocess practice claims, which could mean some physicians will see a boost in reimbursement.

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Posted at 12:30PM Apr 04, 2018 by Kent Moore | Comments [0]

Wednesday Feb 28, 2018

Anthem rescinds modifier 25 cuts

Last week, Anthem, one of the nation's largest commercial health plans, notified the American Medical Association it has decided to not proceed with a policy to reduce payments by 25 percent for evaluation and management codes appropriately reported with CPT modifier 25.

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Posted at 02:45PM Feb 28, 2018 by Kent Moore | Comments [0]

Wednesday Feb 07, 2018

Time to educate your patients about new Medicare cards

CMS has published free resources to help notify your patients that the new Medicare beneficiary cards are coming.

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Posted at 02:30PM Feb 07, 2018 by Barbara Hays | Comments [0]

Thursday Jan 18, 2018

CMS: rate of physicians receiving Value Modifier penalties falls in final year

The Centers for Medicare & Medicaid Services (CMS) has released the results of its 2018 Value Modifier (VM) program (, and fewer eligible physicians will receive a negative payment adjustment than in the past two years.

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Posted at 03:30PM Jan 18, 2018 by Erin Solis | Comments [0]

Thursday Jan 04, 2018

An easier way to report data for QPP has arrived

Medicare is creating a one-stop shop for physicians and practices looking for an easier way to submit information to the Quality Payment Program (QPP).

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Posted at 01:00PM Jan 04, 2018 by Kent Moore | Comments [0]

Monday Dec 04, 2017

Are you getting paid for non-face-to-face prolonged care?

One of the most frequent complaints I hear from physicians is about the work done before and after an office visit, whether done the same day or another day. They say it is frustrating to spend so much time on those activities and receive no payment.

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Posted at 04:30PM Dec 04, 2017 by Betsy Nicoletti | Comments [0]

Friday Nov 10, 2017

Medicare payment news for 2018: the key takeaways

As 2017 draws to a close, the Medicare program is notifying physicians how they will be evaluated and paid for treating patients in 2018. In case you’re not an avid reader of the Federal Register (and most people aren’t), let’s go over some details.

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Posted at 04:15PM Nov 10, 2017 by Kent Moore | Comments [0]

Monday Oct 02, 2017

Medicare payments for lab tests to change in 2018

Does your office perform lab tests for Medicare beneficiaries? The amount of Medicare reimbursement your office receives for those tests is likely changing, and not positively.

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Posted at 05:30PM Oct 02, 2017 by Kent Moore | Comments [0]

Monday Sep 18, 2017

New details as we get closer to CMS replacing current Medicare cards

As I announced in June, the Centers for Medicare & Medicaid Services plans to issue new Medicare identification cards that no longer carry Social Security numbers as a way to prevent fraud and fight identity theft. Last week, CMS unveiled the new cards.

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Posted at 02:45PM Sep 18, 2017 by Kent Moore | Comments [0]

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The views expressed here do not necessarily reflect the opinions of FPM or the AAFP. Some payers may not agree with the advice given. This is not a substitute for current CPT and ICD-9 manuals and payer policies. All comments are moderated and will be removed if they violate our Terms of Use.