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

Medicare

CMS Releases 2020 MIPS Performance Feedback and Final Scores

CMS recently released MIPS performance feedback and final scores for performance year 2020, along with associated MIPS payment adjustment information for payment year 2022. The performance threshold for the 2020 MIPS performance year was 45 points. That means MIPS eligible clinicians who scored 45 points or more will receive a neutral or positive payment adjustment, and those scoring less than 45 points will receive a negative payment adjustment in the 2022 MIPS payment year. READ MORE

2022 Proposed Medicare Physician Fee Schedule: What Emergency Physicians Need to Know

The Centers for Medicare and Medicaid Services recently published the proposed draft of the Medicare Physician Fee Schedule for 2022. In addition to the annual conversion factor update, the Proposed Rule also recommends changes to several payment policies. We’ve highlighted a few of the biggest for emergency physicians below. READ MORE

2022 Proposed Medicare Physician Fee Schedule: What You Need to Know

The Centers for Medicare and Medicaid Services recently published the proposed draft of the Medicare Physician Fee Schedule for 2022. At the heart of the MPFS is the annual conversion factor update. After legislatively mandated adjustments, including the expiration of the 3.75 percent payment increase provided for CY 2021 by the Consolidated Appropriations Act, the 2022 conversion factor will be $33.58, a $1.31 (or 3.75 percent) decrease from the final CY 2021 PFS conversion factor of $34.89. READ MORE

2022 Proposed Medicare Physician Fee Schedule: What Anesthesiologists Need to Know

The Centers for Medicare and Medicaid Services recently published the proposed draft of the Medicare Physician Fee Schedule for 2022. In addition to the annual conversion factor updates, including the anesthesia conversion factor, the proposed rule includes several payment policy updates. We’ve highlighted a few of the biggest changes for anesthesiologists. READ MORE

When Medicare Denies As Secondary Payer

Some patients with Medicare also have other health insurance coverage through an employer or spouse’s employer, or on a case by case basis for accidents, injuries, or illnesses covered by workers compensation, liability, or no-fault Insurance. In those cases, Medicare serves as the secondary payer (MSP). In some situations, though, Medicare may deny a claim indicating that Medicare is the secondary payer when, in fact, you have no primary payer on file. When this is the case, what should you do? READ MORE

CMS Releases Critical Care CBRs for Second Year in a Row

The Centers for Medicare and Medicaid Services is once again releasing Comparative Billing Reports to some providers who perform critical care evaluation and management services. This time, they will be analyzing claims that occurred in part during the COVID-19 public health emergency, with dates of service from Jan. 1, 2020, through Dec. 31, 2020. READ MORE

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