New guidance on Good Faith estimates
Last week the Centers for Medicare and Medicaid Services (CMS) published new guidance that provides important clarifications about the content of Good Faith Es…
Are consultation codes obsolete?
In 2010 the Centers for Medicare and Medicaid Services stopped paying for consultation codes. While it continued to recognize the concept of consults, it paid …
Advocacy Council pushes to extend sequester moratorium
Since 2020, the 2% Medicare sequester moratorium has been in effect – and we are urging Congress to continue it through the end of the public health emergency …
Dealing with Modifier -25 denials for office visits and skin testing
The Advocacy Council regularly receives queries from members on how to correctly code specific scenarios. Recently we received a request for coding an office v…
Telehealth services: Can you provide them for your out-of-state patients?
As the public health emergency (PHE) continues and issues related to COVID-19 change quickly, you may be wondering whether you can continue to provide teleheal…
CPT Codes for testing to local anesthetics
The Advocacy Council regularly receives queries from members on how to correctly code specific scenarios. Recently we received a request for coding a local ane…
2022 Medicare Principal Care Management codes
In the Medicare Physician Fee Schedule final rule issued last November, the Centers for Medicare and Medicaid Services (CMS) added four new CPT codes in the ca…
2022 RVUs and Medicare physician fee schedule effective now
The College’s Advocacy Council, along with other organizations, has been successful in advocating for legislation to alter Medicare physician payment cuts sche…
Remote Therapeutic Monitoring – New revenue for allergists?
On Jan.1, 2022, Medicare will begin paying for remote therapeutic monitoring (RTM) services. RTM services allow for nonphysiologic data to be collected. Data c…
College advocacy largely averts Medicare pay cut
As you know, many allergists were facing reductions in Medicare payments that could have been as high as 9.75% beginning Jan. 1 if Congress did not step in to …
Open season for deciding Medicare participation
Every year, between mid-November and December 31, physicians have the opportunity to change their Medicare participation status for the following year. Physici…
Final 2022 Physician Fee Schedule
CMS released the final 2022 Medicare physician fee schedule rule on November 2, 2021. The new rates take effect on January 1, 2022. CMS estimated the policy ch…
Correction: When to count tests for E/M coding based on MDM
There has been a great deal of confusion regarding how to count tests/procedures for purposes of coding office visits based on medical decision making (MDM), a…
More clarification of 2022 proposed fee schedule
New Medicare billing rights for physician assistantsBeginning Jan. 1, 2022, physician assistants (PAs) will be able to bill Medicare independently for their se…
More E/M coding direction
The 2020 physician fee schedule finalized changes in evaluation and management (E/M) codes that became effective Jan. 1, 2021. It quickly became evident from p…
We clarify Evaluation and Management codes
This article has corrected information as of July 22, 2021.The 2020 physician fee schedule finalized changes in evaluation and management (E/M) codes that beca…
Need guidance on E/M codes based on time?
The 2020 physician fee schedule finalized changes in evaluation and management (“E/M”) codes that became effective Jan.1, 2021. It quickly became evident from …
Billing for Mid-level practitioners
Many commercial payers have begun to require that services performed by mid-level practitioners be billed under the National Provider Identifier (NPI) number …
AAP payments may begin in April
Early in the pandemic, the Centers for Medicare and Medicaid Services (CMS) offered Medicare providers loans, based on past Medicare billing, to help strugglin…
Summary of the American Rescue Plan
Last week, President Biden signed the $1.9 trillion American Rescue Plan (ARP), which provides new COVID-19 relief as well as establishes other policies. The D…
