Understanding PAR and non-PAR Providers with Medicare

PAR and non-PAR Providers with Medicare The Center for Medicare & Medicaid Services (CMS) is a federal agency within the Department of Health and Human Services which manages and oversees the Medicare program for beneficiaries. Physicians are required to comply with numerous laws and regulations related to various aspects of their practice within the Medicare […]


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Documentation for Interventional Radiology

Documentation for Interventional Radiology Many interventional radiologists believe their only audience is the referring physician and fails to remember that there is a larger financial audience which includes medical coders, insurance carriers, auditors, and reviewers to name a few. Even though you know in detail the procedure you performed, unless it is clearly documented using […]


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Appropriate Use of Modifier 25 in Cardiology

Defining Modifier 25 Modifier 25 is defined as a significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service. It may be necessary to indicate that on the day a procedure or service identified by a CPT code […]


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Understanding Synchronous & Asynchronous Telehealth 

When researching your options for telehealth and telehealth solutions, you will likely hear about the two forms of telehealth: synchronous and asynchronous. Understanding how these forms of telehealth differ and what makes each a worthwhile form to consider is critical to achieving the goals of your telehealth program. In this blog, we will define these […]


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CPT Codes for Digital E/M Service

In the 2020 CPT codes set, CMS six released new codes to report online digital evaluation services or e-visits. The codes describe patient-initiated digital communications provided by physicians or other qualified health professionals, codes are 99421, 99422, and 99423. Three others who describe similar interactions when they involve a nonphysician health professional are 98970, 98971, […]


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Basics of Value-Based Care

Basics of Value-Based Care The patient reimbursement model plays a crucial role in patient satisfaction, providers are always trying to improve the patient experience by reducing the cost of service. Most providers use a fee-for-service (FFS) model, which incentivizes physicians based on the number of services provided instead of the quality of care. But value-based […]


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CMS Telehealth Services After PHE

The 2022 Medicare Physician Fee Schedule Final Rule released on November 2, 2021, by the Centers for Medicare & Medicaid Services (CMS) added certain services to the Medicare telehealth services list through December 31, 2023. Last year, CMS included temporary ‘Category 3’ services to the Medicare services list for the duration of the COVID-19 public […]


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Revised Guidelines for Split (or Shared) E/M Visits and Critical Care Services

On November 2, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates on policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, on or after January 1, 2022. In the final rule of the 2022 Medicare Physician Fee Schedule, the […]


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What is MPFS (Medicare Physician Fee Schedule)?

Basics of Medicare Physician Fee Schedule As the name suggests Medicare Physician Fee Schedule (MPFS) is a complete listing of fees used by Medicare to pay doctors or other providers/suppliers. This comprehensive listing of fee maximums is used to reimburse a physician and/or other providers on a fee-for-service basis. Medicare Part B pays for physician […]


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Billing Telepsychiatry for Interstate

In the year 2021, we observed increased use of telehealth services as patients look for ways to continue their treatment while following physical distancing guidelines. This also created unique scenarios including patients and providers in different states during telepsychiatry sessions. When engaging in interstate practice, psychologists should comply with all relevant laws and regulations, both […]


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