COVID-19 Reimbursement for Uninsured Patients

Community Health Centers (CHC) are eligible for reimbursement for the testing and treatment of COVID-19 patients who are uninsured. The Families First Coronavirus Response Act (FFCRA) Relief Fund appropriated $1 billion to reimburse providers for conducting COVID-19 testing for the uninsured; and the Provider Relief Fund appropriated additional funds to reimburse providers for treating uninsured […]

Evaluation and Management (E&M) Coding Changes for 2021

CMS and the American Medical Association have announced big changes in E&M coding for 2021. These changes were implemented to help ease the burden of documentation requirements for providers. Currently E&M code selection is on a points-based system consisting of three key components: history, examination and medical decision making. Under the 1995/1997 rules, for each […]

United Healthcare to Require Anatomical Modifiers

Beginning with claims submitted on or after May 1, 2018, care providers will be required to include an anatomical modifier that identifies the area or part of the body for procedures performed on the eyelids, fingers or toes. This coding edit is consistent with Centers for Medicare & Medicaid Services (CMS) correct coding guidance and […]

Billing for Chronic Care Management

** UPDATE FOR 2017 ** An estimated 117 million adults have one or more chronic health conditions, and one in four adults have two or more chronic health conditions. Chronic disease is prevalent among Medicare beneficiaries, with most beneficiaries having multiple chronic conditions, which increases the risk for poor health outcomes such as mortality and […]

Flu Shots for the 2016-2017 Season

The CDC recommends trivalent and quadrivalent flu vaccines for 2016-2017. There are different flu shots based upon different age groups as well. Trivalent Flu Vaccines The trivalent vaccine is a three component vaccine. The trivalent flu vaccine is a three-component flu vaccine. This vaccine can come as a standard-dose trivalent shot (IIV3), high-dose trivalent shot […]

MACRA – Final Rule

Medicare Physician Billing Services for Raleigh, NC & West Palm Beach, FL Breaking: Medicare finalizes sweeping changes to physician payments Today, the Centers for Medicare & Medicaid Services (CMS) released the highly-anticipated final rule implementing the Medicare physician payment reforms enacted as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). With […]