The Medicare sequestration cuts, rolled back at the beginning of the year by Congress to offset a potentially devastating reduction in physician payments, will be phased back in beginning April 1. Despite efforts by the physician community and other stakeholders to lobby Congress to [...]

The American Medical Association (AMA) CPT Editorial Panel recently approved a new Current Procedural Terminology (CPT) modifier for “Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System.” Modifier 93 should be reported to describe real-time telemedicine services between a patient [...]

In November the Centers for Medicare and Medicaid Services (CMS) finalized proposals and outlined its plans to completely restructure the Merit-based Incentive Payment System (MIPS) program. This comes as no surprise, as CMS introduced the concept of MIPS Value Pathways through the rulemaking process [...]

Congress passed legislation (S610) that will reduce or delay many of the Medicare physician reimbursement cuts that were set to go into effect Jan. 1, 2022. President Biden signed S610 into law on Dec. 10. The law will reduce or delay the following Medicare [...]

Merit-based Incentive Payment System (MIPS) eligible clinicians, groups, and virtual groups may apply to reweight any or all MIPS performance categories if they’ve been affected by extreme and uncontrollable circumstances that impact these categories. Extreme and uncontrollable circumstances are defined as rare events entirely [...]

The Centers for Medicare and Medicare Services (CMS) is repealing the “Medicare Coverage of Innovative Technology and Definition of “Reasonable and Necessary” final rule. In rescinding the rule, CMS acknowledges concerns that requirements in the final rule may be inadequate to safeguard Medicare patients. [...]