Practice Management
The Centers for Medicare and Medicaid Services’ plan to transition from a Social Security number-based ID system to a randomly generated identifier is moving forward. The agency won’t start mailing new cards until April 2018, and the whole process will take nearly 2 years to complete, but in the meantime CMS is rolling out a provider- and patient-awareness campaign to assure the transition is as smooth as possible. The new Medicare beneficiary identifier (MBI) will …
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As antibiotic resistance continues to grow, organizations from the Urgent Care Association of America to the Antibiotic Resistance Action Center to the Centers for Disease Control and Prevention have asked their audiences to take a close look at what they can do to curb unnecessary prescriptions that exacerbate the problem. (The cover article in the May issue of JUCM will look at how one institution tackled this problem, as well.) Now the Centers for Medicare …
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The Centers for Medicare & Medicaid Services is going to issue new Medicare cards, replacing beneficiaries’ Social Security numbers with unique ID numbers, by April 2019. However, the Health & Human Services Advisory Panel on Outreach and Educations says CMS isn’t doing enough to share more about the process with healthcare providers, who will have to make significant changes in their billing practices as the new ID card system is implemented gradually; CMS will start …
Read MoreQ: We are coding for an urgent care group that is owned by a hospital and bills on a CMS-1500 for professional services and the UB-04 for facility services. We bill using Place of Service (POS) code 22. Is this correct? A: Prior to January 1, 2016, the Centers for Medicare and Medicaid Services (CMS) POS code set did not differentiate between an urgent care operating on campus or off campus. As of January 1, …
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Alabama says it’s just trying to protect its coffers from being pilfered by criminals, but the Centers for Medicare & Medicaid Services is taking a hard look at how the state is handling cases of alleged fraud by Medicaid enrollees. The state acknowledges that it rejects people who would otherwise be eligible for Medicaid funding if those individuals “have been found” to have engaged in fraud—even if they were never convicted of a crime, which …
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The next decade will see national health expenditures grow 5.6% annually, according to projections from the Centers for Medicare & Medicaid Services (CMS), ensuring that the need for cost-effective, high-quality care will continue to grow as well. If CMS’s Office of the Actuary is correct in its estimate, the jump in healthcare spending will outpace projected growth of the Gross Domestic Product (GDP) by 1.2%. The portion of the GDP consumed by healthcare spending is …
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The Centers for Medicare & Medicaid Services (CMS) says patients reporting to emergency rooms in Maryland are likely to wait over twice as long as the national average—53 minutes vs 22 minutes. Greater Baltimore Medical Center (BMBC), whose ED clocked an average wait time of 60 minutes, suggested patients could get in and out much more efficiently if nonemergent patients sought care in a more appropriate environment, such as BMBC’s primary care offices. This echoes …
Read MoreQ: Can you bill for splint and cast applications done by someone on staff other than the physician? A: Yes, you can still bill for the service if the application is performed by someone else in the clinic. The American Medical Association (AMA) provided guidance on this in the Current Procedural Terminology (CPT) Assistant, April 2002 issue: “You will note that the reference to ‘physician’ has been retained in the clinical examples provided. This inclusion …
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Urgent care doctors, physician assistants, and nurse practitioners who did not demonstrate that they met requirements for meaningful use of electronic health record systems as mandated by the Centers for Medicare & Medicaid Services (CMS) will see a 3% decrease in Medicare payments starting January 1, 2017. As you read here, CMS first announced its plans to require clinicians to show meaningful use during a finite 90-day period that year. That finite period was later …
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The Centers for Medicare and Medicaid Services (CMS) will ask Medicare beneficiaries how their healthcare providers are doing under the new Merit-based Incentive Payment System (MIPS), which was supposed to help improve the quality of care while lowering cost. No revelations are expected, however, because the survey is voluntary and CMS has taken a relaxed approach to getting providers on board with the new system. In addition, survey results—which, presumably, will be made public to …
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