The rising complexity and cost of emergency care has been a frequent target of policy makers and clinical leaders over the past decade, with some experts worried about the cascading effect of subsequent healthcare spending once the patient leaves the emergency department. However, new research suggests that high quality emergency care not only saves lives but also saves money, especially for Medicare beneficiaries. READ MORE
The Centers for Medicare and Medicaid Services (CMS) recently published the proposed draft of the Medicare Physician Fee Schedule (PFS) for 2021. In addition to changing the payment rates for 2021, the Final Rule also mandates changes to several payment policies. We’ve highlighted a few of the biggest changes that will impact emergency physicians. READ MORE
Physicians and other MIPS-eligible providers affected by the COVID-19 pandemic may be eligible for a 2020 MIPS Extreme and Uncontrollable Circumstances Exception. The hardship exception application allows providers to request one or more performance categories be reweighted to 0 percent. READ MORE
It doesn’t just seem like emergency departments are seeing fewer patients than usual during the COVID-19 pandemic. ERs across the country actually are seeing around 40 to 50 percent fewer patients. A recent ACEP poll offers a few reasons why. READ MORE
Here are 15 things to know about billing Medicare and Indiana Medicaid for telehealth services in the ED during the COVID-19 public health emergency. READ MORE
The deadline for physicians and other eligible providers to submit data for the 2019 MIPS reporting period has been extended. Providers now have until April 30, 2020, rather than March 31, to submit MIPS data. READ MORE
Individual clinicians and provider groups hoping to take advantage of the facility-based measurement for the 2020 MIPS Quality and Cost performance categories can now check their facility-based status with the updated participation status tool on the Quality Payment Program website. READ MORE
All Indiana Medicaid MCEs who choose to use a list of diagnosis codes to determine whether to cover emergency department claims must use a state-compiled standardized list beginning April 1, 2020. READ MORE
United Healthcare will begin evaluating all level 5 professional Emergency Department claims and potentially downcoding them or denying them for “inappropriate” coding. The new policy, which takes effect April 1, 2020, is part of the payer’s “continued efforts to reinforce accurate coding practices.” READ MORE
CMS recently published the final draft of the Medicare Physician Fee Schedule for 2020. In addition to changing the payment rates for 2020, the Final Rule also mandates changes to several payment policies. We’ve highlighted a few of the biggest changes that would be most interesting to emergency physicians. READ MORE
