Experience. Integrity. Advocacy.
Experience. Integrity. Advocacy.


Medicare Denies Payment for Add-on Conscious Sedation Code

Physicians taking advantage of new unbundled codes for billing moderate or conscious sedation are receiving denials from Medicare for one of them. That code, 99153, which is the add-on code for additional time spent administering conscious sedation by a provider who’s also performing the primary service, has been denied by Medicare when the service was performed in a facility setting. Read more

Final Year’s Results for the PQRS and Value Modifier Programs Now Available

The Medicare PQRS and Value Modifier programs may feel like a distant memory for providers who are now in the thick of trying to figure out the new MACRA Quality Payment Program guidelines. Unfortunately, some providers may still experience the negative effects of these sunsetting programs as the Centers for Medicare and Medicaid Services releases the results of the final reporting year and how they will affect provider payments. Read more

ASA Hopes to Make 2018 QPP More Anesthesia-Friendly

The ASA recently submitted comments to CMS related to the 2018 Quality Payment Program Proposed Rule. The goal of their 28-page letter, according to a prepared statement by the ASA, is to ensure “physician anesthesiologists have ample opportunities to meaningfully participate and succeed in either the Merit-based Incentive Payments System or Advanced Alternative Payment Models pathways under the QPP.” Read more

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