Newsletters

CMS has posted the 2012 Medicare Physician Fee Schedule (MPFS) on their website
November 1, 2011. All payment and policies were to be effective January 1, 2012...

The Centers for Medicare and Medicaid Services (CMS) announced changes to the Medicare Electronic Prescribing (eRx) incentive program for Calendar Year 2011...

There are 169 new, 42 revised and 34 deleted ICD-9-CM codes recently finalized for 2012. The changes become effective October 1, 2012.

Effective July 1, 2011, Optima Health will no longer accept consultation codes for all commercial and self-funded accounts. All consultation services should be reported using the appropriate E/M code.

It is not too late to start participating in the 2010 Electronic Prescribing Incentive Program (eRx). Providers may still qualify to receive a full-year incentive payment for 2011.

On September 9, 2010, CMS announced that Palmetto GBA will begin implementation of the new Jurisdiction 11 (J11) A/B Medicare Administrative Contract...

The Senate has passed legislation that prevents a 24.9 percent cut in Medicare physician payments. This bill averts a 25 percent Medicare payment cut that was scheduled to take effect January 1, 2011. The Medicare and Medicaid Extenders Act of 2010 extends the current Medicare payment rates through December 31, 2011...

In a special memo dated September 2, 2010, Virginia Department of Medical Assistance Services (DMAS) announced rate changes as a result of additional Medicaid funding and other program changes. Effective October 1, 2010, the Appropriation Act authorized and rescinded the rate cuts that went into effect in July 2010 for dates of service October 1, 2010 through June 30, 2011. DMAS did not make the changes retroactive. Claims for dates of service between July 1, 2010 and September 30, 2010 will be reimbursed at the reduced rates...

CMS has posted the new, revised and invalid diagnosis codes that will go into effect on October 1, 2010.
There are 122 new diagnosis codes. Most of the new diagnosis codes involve ―V‖ codes (supplementary classification of factors influencing health status and contact with health services). Specifically, the body mass index (BMI) 40 and over, adult codes (V85.4 has been expanded into 5 new codes) and Congenital Malformations codes (V13.62 – V13.68)...

On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), which amended the time period for filing Medicare fee-for-service (FFS) claims. In the past, claims had to be filed no later than the end of the calendar year following the year during which the service was furnished. An exception was provided when a service was performed in the last 3 months of the year (October, November, and December)...