CMS’ 2019 OPPS proposed rule continues the agency’s efforts to enforce site-neutral payments and reduce drug payments by introducing policies to reduce reimbursement for hospital outpatient clinic visits at off-campus, provider-based departments (PBD) and expanding last year’s payment reductions for drugs purchased under the 340B discount pricing program by nonexcepted PBDs.
CMS would use the proposed modifiers to implement a 15% payment reduction starting in 2022 for services provided in whole or in part by physical therapy assistants (PTA) and occupational therapy assistants (OTA).
Integrating facility and professional fee coding into one centralized department model can help organizations make the most of advances in technology and manage costs.
CMS recently released new documentation guidance on medical review of E/M services performed by medical students. A medical student may document E/M services if the physician performs or re-performs the exam and then verifies the student’s documentation.
Payers rely heavily on the use of data and data analytics to manage their risk. Follow these tips for using payer guidelines to understand what they’re looking for and how to improve documentation.
