CMS

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2023 Proposed PFS Rule Policies Examined

As discussed last month, the 2023 Medicare Physician Fee Schedule (PFS) rule has arrived, released by the Centers for Medicare & Medicaid Services (CMS) on Tuesday, July 7, 2022. The proposed rule outlines potential updates to a variety of policies and provisions that dictate payment for many services included in

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Reimbursement Decreases on the Horizon With the 2023 Proposed PFS Rule

The 2023 Medicare Physician Fee Schedule (PFS) rule has arrived, released by the Centers for Medicare & Medicaid Services (CMS) on Tuesday, July 7, 2022. Radiology will once again experience a threat to payments as the pandemic continues to bring consequences for healthcare. As usual, the proposed rule outlines potential

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Reviewing the 2022 Proposed Medicare Physician Fee Schedule Rule

Radiology stakeholders are still working to understand and absorb the potential impacts of the 2022 Medicare Physician Fee Schedule (PFS) proposed rule released by the Centers for Medicare & Medicaid Services (CMS) on Tuesday, July 13, 2021, as the final rule approaches. Radiology will once again experience a threat to

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General Compliance Question of the Week

General Question for the Week of July 12, 2021

Regarding the Appropriate Use Criteria (AUC) program, CMS recently stated “Currently, the program is set to be fully implemented on January 1, 2022, which means AUC consultations with qualified CDSMs are required to occur along with reporting of consultation information on the furnishing professional and furnishing facility claim for the advanced diagnostic imaging service. Claims that fail to append this information will not be paid.” Our hospital images are read by an outsourced radiology group. Will the hospital still receive payment for the technical portion if AUC requirements are not met? Will the radiologist’s claim be completely denied?

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Laboratory Coding Updates and Changes for 2021

January 1, 2021 has arrived  and with it are the latest CPT® code changes made by the American Medical Association (AMA) effective at the start of the year.  The current codes, guidelines, and parenthetical changes can be found in the 2021 CPT Professional code book. Below is an overview of

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