There has been much discussion and controversy over the new CMS position on billing for split/shared services in facility settings.
As originally proposed, and starting in January 2022, if the service was shared among providers (such as physicians and physician assistants), the provider who performed the substantive portion of the visit would be the provider…
Under the Federal Ethics in Patient Referrals Act (more commonly known as “Stark”), if a physician[1] has a financial relationship with an entity, the physician may not refer patients to the entity for medical services payable by Medicare unless the financial relationship complies with the Stark safe harbors. Thus, entities that lease or sublease…
In MLN Matters article MM 12159, CMS has published summaries of the following:
MLN Connects, on Monday August 16, 2021, published a special edition on COVID-19 vaccines codes and payment. It references the CMS explanation entitled “Medicare COVID-19 Vaccine Shot Payment”.
I have also attached a PDF of both documents if you cannot access the links.
The 2022 Medicare Physician Fee Schedule was proposed and published by CMS on Friday, July 23, 2021. Here is the link: https://www.govinfo.gov/content/pkg/FR-2021-07-23/pdf/2021-14973.pdf
The correct Medicare conversion factor for 2021 is $34.8931. I apologize for the math error.
Click here to read the article on the 2021 Medicare Physician Fee changes which appeared in the March 2021 edition of the Allegheny County Medical Society Bulletin.
CY 2021 Physician Fee Schedule Update
On December 27, 2020, the Consolidated Appropriations Act modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS):
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This article written by Michael A. Cassidy and Jerry J. Russo appeared in the October 2020 Issue of the Allegheny County Medical Society Bulletin.
On September 24, 2020, President Trump issued an Executive Order encouraging Congress to restrict surprise billing and prevent third party payors from denying care to patients with pre-existing conditions. President Trump wants Congress to act prior to the end of the year, but obviously there is not much chance of that happening.
