CMS Updates

A podiatrist evaluates a patient’s new complaint and performs a necessary procedure during the same visit. When the evaluation is significant and separately identifiable, Modifier 25 allows the practice to report both services.

Medicare has published a new version of the Advance Beneficiary Notice of Non Coverage Form (ABN).

Update from CMS

The net result is a decrease in payments of 3.89%. How does this break down?

Think of it as being graded on the curve. If you score a 95 on a test you think you have a good grade, but if class average on that test was a 98 you will get a poor grade. Scoring for quality measures is similar to that type of grading.

They are stating that these exemptions are Automatic.  But what does that really mean?

This means that the CMS 1135 Waivers have been extended through April 20. Some of the waivers may impact your practice while most of the waivers are related to hospital care.

For the 2020 performance period, CMS is using the Extreme and Uncontrollable Circumstances policy to allow clinicians, groups, and virtual groups to submit an application requesting reweighting of one or more MIPS performance categories due to the COVID-19 pandemic. As an additional flexibility, CMS has extended the deadline to submit a COVID-19 related 2020 extreme and uncontrollable circumstances application to February 1, 2021.

The Coronavirus Aid, Relief, and Economic Security (CARES) Act suspended the payment adjustment percentage of 2% applied to all Medicare Fee-For-Service (FFS) claims from May 1 through December 31. The Consolidated Appropriations Act, 2021, signed into law on December 27, extends the suspension period to March 31, 2021

Recently Medicare expanded their definition of the health care provider who can certify the patient as being diabetic. This brief article will answer some questions, but many others remain unquestioned.