Category: Reimbursement

CMS finalizes calendar year 2019 and 2020 payment and policy changes for Home Health Agencies and Home Infusion Therapy Suppliers

CMS finalizes calendar year 2019 and 2020 payment and policy changes for Home Health Agencies and Home Infusion Therapy Suppliers On October 26, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule setting out finalized Calendar Year (CY) 2019 Medicare payment updates, finalized quality reporting...

Telehealth and the law: the challenge of reimbursement

Technological advances continue to expand the healthcare delivery marketplace. Through technology, more and more providers are trying to cash in on telehealth. As with any other business, the healthcare industry is driven by profitability. In healthcare, profitability is generally driven by reimbursements from government payers such as Medicare and...

AMA Adds Connected Health CPT Codes, Pushes for Medicare Payment

The 2019 CPT code set includes new remote patient monitoring and internet consulting codes to encourage innovative care delivery and Medicare payment for connected health. September 07, 2018 – The American Medical Association (AMA) updated the Current Procedural Terminology (CPT) code set in 2019 to include new codes for connected...

AMA Releases 2019 CPT Code Set

CHICAGO—The American Medical Association (AMA) today announced the release of the 2019 Current Procedural Terminology (CPT®) code set. There are 335 code changes in the new CPT edition reflecting the CPT Editorial Panel and the health care community’s combined annual effort to capture and describe the latest scientific and technological advances...

ACOs taking risk in innovative payment model generate savings for patients and taxpayers

Aug 27, 2018 Today, the Centers for Medicare & Medicaid Services (CMS) released an evaluation report for the first performance year of the Innovation Center’s Next Generation Accountable Care Organization (ACO) Model showing promising early results. Results demonstrated the positive outcomes in terms of quality and costs when providers...

2019 Medicare Physician Fee Schedule and Quality Payment Program – CMS Proposed Rule – CPT Codes 990X0, 990X1, and 994X9 – Everything You Need to Know

CMS has proposed three new codes for RPM services, retitled “Chronic Care Remote Physiologic Monitoring,” which do a far better job reflecting how providers can more effectively and efficiently use RPM technology to monitor and manage patient care needs, including chronic care management.  If finalized, these three codes would...

After-Hours Telemedicine Helps Skilled Nursing Facilities Avoid Unnecessary Hospitalizations, AJMC® Study Finds

August 20, 2018 As skilled nursing facilities handle more complex care, the need arises for physician input before sending patients to the hospital. Study findings reported this month in The American Journal of Managed Care® show that using telemedicine for this purpose can lead to fewer hospitalizations and savings for Medicare....

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