Clinical Resources Articles
These sleep medicine articles include updates about coding and reimbursement, new practice guidelines, and telemedicine. To view our case study of the month, visit the AASM sleep medicine case studies page.
Eligible professionals participating in the Medicare or Medicaid Electronic Health Record (EHR) incentive program must complete their reporting period by the end of 2012 in order to receive an incentive payment.
In a Nov. 28 report, the Centers for Medicare & Medicaid Services announced that $692 million in electronic health record (EHR) incentive payments were distributed to eligible providers in October. Total payments, which began in 2011, have now reached $8.4 billion.
The 2013 Medicare Physician Fee Schedule (MPFS) final rule was published on Nov. 16. The fee schedule finalizes payment rates for all physician services, including payment rates for sleep testing. Payment for all services in the MPFS is calculated by multiplying the relative value units (RVUs) assigned to each component of the service by the designated conversion factor for the year. This article provides summary information about the payment rates for sleep testing effective Jan. 1, 2013.
On November 1, the Department of Health and Human Services (HHS) published the display copy of final rule for the 2013 physician fee schedule. The rule describes a 26.5 percent payment cut for all services based on the Sustainable Growth Rate (SGR) formula.
The Centers for Medicare and Medicaid Services (CMS) has announced the clinical quality measures for the Electronic Health Record (EHR) Incentive Program. Starting in 2014, all providers will be required to report the new clinical quality measures regardless of whether they are participating in Stage 1 or Stage 2 of the EHR incentive program.
On Nov 1, 2012, the Centers for Medicare & Medicaid Services (CMS) will begin accepting hardship exemption requests for the 2013 Electronic Prescribing (eRx) payment adjustment. Exemption requests will be accepted through Jan 31, 2013. Hardship exemptions must be submitted electronically through the Quality Reporting Communication Support web page.
A recent survey conducted by the Medical Group Management Association (MGMA) shows the potential negative impacts of Medicare’s proposed 27% payment cut for 2013. The cut, a result of the sustainable growth rate (SGR) formula, is scheduled to take effect Jan 1, 2013 unless Congress takes action by delaying cuts or repealing the SGR.
This month, the American Medical Association (AMA) published the 2013 edition of the CPT codebook. The AASM is excited to announce that CPT 2013 includes two new codes for pediatric polysomnography.
On Tuesday, Oct. 2, the Office of the Inspector General (OIG) published their Work Plan for 2013. The OIG Work Plan describes activities the OIG will initiate or continue throughout the year. Through its activities, the OIG seeks to fight waste, fraud and abuse in the US Department of Health and Human Services (HHS) programs such as Medicare.
On Oct. 1, the Centers for Medicare & Medicaid Services (CMS) implemented two new programs under the Affordable Care Act. The Hospital Value-Based Purchasing Program emphasizes quality of care in the hospital setting by shifting toward a pay-for-performance model. Under the new program, Medicare will withhold 1 percent of reimbursements to acute-care hospitals and redistribute these funds to hospitals that meet high performance standards.