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Jan 20, 2025 | 
pbn.decisionhealth.com | Julia Kyles |Roy Edroso |Richard Scott
A proposed rule from HHS would confirm that cybersecurity measures such as multi-factor authentication (MFA) and encryption of electronic protected health information (ePHI) are not optional safeguards, but something covered entities such as physician practices are required to implement to stay compliant with HIPAA. Because of the way the policies are directed, experts say you should work to meet the proposed rule’s requirements whether or not the rule is finalized.
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Jan 18, 2025 | 
pbn.decisionhealth.com | Julia Kyles |Roy Edroso |Richard Scott
CMS updated the guidelines for reporting an E/M service on the same day as a procedure with an XXX global surgery indicator – global surgery concept does not apply – in the latest National Correct Coding Initiative (NCCI) Manual. You must log in to view the content you requested. Not a subscriber?
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Jan 16, 2025 | 
pbn.decisionhealth.com | Julia Kyles |Roy Edroso |Richard Scott
Teach the tighter modifier 25 guidelines in the 2025 National Correct Coding Initiative (NCCI) Manual and pass along the latest updates on mutually exclusive edits. You must log in to view the content you requested. Not a subscriber?
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Jan 16, 2025 | 
pbn.decisionhealth.com | Julia Kyles |Richard Scott |Roy Edroso
As of Jan. 1, practices are eligible to report visit complexity add-on code G2211 with office visit codes 99202-99215 when appending modifier 25 to the primary E/M code. However, take note of the billing restrictions that CMS placed on the same-day services eligible for the billing opportunity. You must log in to view the content you requested. Not a subscriber?
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Oct 16, 2024 | 
pbn.decisionhealth.com | Julia Kyles |Laura Evans |Richard Scott |Roy Edroso
Take in the details of the 16 new telemedicine codes for real-time encounters in the CPT 2025 manual while you wait to see whether private payers adopt the services or CMS sways from proposed non-coverage of the codes.
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Oct 16, 2024 | 
pbn.decisionhealth.com | Laura Evans |Julia Kyles |Richard Scott |Roy Edroso
Get ready to dig into more than 400 code changes as part of the 2025 CPT code set. That includes 270 new codes, including dozens of surgical codes, as well as 112 deletions and 38 revisions.
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Oct 16, 2024 | 
pbn.decisionhealth.com | Roy Edroso |Laura Evans |Julia Kyles |Richard Scott
A big drop in the star ratings for Medicare Advantage plans is just the latest in a series of recent challenges to the public-private coverage program. MA enrollments are increasingly up and set to outstrip traditional Medicare, but challenges like this one are increasingly noisy. While this doesn’t mean the program will reverse course, some payers already are making big changes to cope.
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Jul 18, 2024 | 
pbn.decisionhealth.com | Laura Evans |Richard Scott |Julia Kyles
Practices can get a first glimpse of new codes they can expect to see in the 2025 CPT manual in the proposed fee schedule, as CMS proposes work valuations for them. The agency also floated new HCPCS services. You must log in to view the content you requested. Not a subscriber?
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Jul 18, 2024 | 
pbn.decisionhealth.com | Richard Scott |Laura Evans |Julia Kyles
You can say goodbye to the elevated payment rates that have buoyed Part B professional fees for most of 2024. Should CMS’ proposals in the latest physician fee schedule hold, providers and medical groups will see a nearly 3% reduction to the Medicare Part B conversion factor in 2025. You must log in to view the content you requested. Not a subscriber?
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Jul 18, 2024 | 
pbn.decisionhealth.com | Julia Kyles |Richard Scott |Laura Evans
COVID-19 public health emergency (PHE) policies will be a factor in CMS telehealth policy even after the existing telehealth waivers expire on Dec. 31, 2024. You must log in to view the content you requested. Not a subscriber?
