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…
Can mid-level practitioners provide skin testing?
Many allergists are assisted by nurse practitioners (NPs) and/or physician assistants (PAs) in providing care in the office. The Advocacy Council frequently re…
2021 E/M coding and documentation rules
New rules for reporting outpatient office evaluation and management (E/M) services took effect Jan. 1. The coding and documentation revisions, adopted by the …
Good news for allergist payment
The Centers for Medicare and Medicaid Services (CMS) revised the 2021 Medicare Physician Fee Schedule (MPFS) rates and conversion factor (CF) following changes…
What are the 2021 RVUs for allergy codes?
The Medicare Physician Fee Schedule (PFS) for 2021 was released on Dec. 1, 2020 and becomes effective on Jan. 1, 2021. The Centers for Medicare and Medicaid Se…
Medicare finalizes complexity add-on code G2211 for 2021
On December 1, 2020, the Centers for Medicare and Medicaid Services (CMS) released its Medicare Physician Fee Schedule (PFS) final rule, which takes effect on …
Trump administration issues regulations to lower prescription drug prices
On Nov. 20th, the Trump Administration issued new regulations intended to lower the cost of prescription drugs covered by both Medicare Part B and Part D. Redu…
Billing for biological products
The Advocacy Council recently learned of a number of payer audits and recoupment requests related to Xolair billing - when a portion of the vial must be discar…
New CMS MIPS cost measure will impact allergists
The Advocacy Council recently submitted comments to the Centers for Medicare & Medicaid Services (CMS) about a proposed Asthma/COPD cost measure in the Cos…
New prolonged service CPT code for 2021
Beginning in 2021, there will be a new code for reporting prolonged services together with an office visit. The new code, CPT Code 99417, replaces CPT Codes 99…
Telemedicine use: Where are allergists now?
The College’s two recent COVID-19 member surveys indicate telemedicine use initially soared among allergists during the first months of COVID-19, and then drop…
Big changes coming in E/M coding and payment
Beginning January 1, 2021, there will be new rules for reporting and documenting outpatient evaluation and management (E/M) services. These changes, which are …
Proposed QPP and MIPS changes for 2021
The Centers for Medicare and Medicaid Services (CMS) is proposing a number of changes to the Quality Payment Program (QPP) and the Merit-based Incentive Paymen…
Appropriate Use Criteria start date delayed until CY 2022
The Centers for Medicare and Medicaid Services announced the Appropriate Use Criteria (AUC) Program testing period has been extended through CY 2021. Clinician…
CMS announces proposed Medicare rates and policies for 2021
The Centers for Medicare and Medicaid Services (CMS) has announced a number of proposed policy and payment changes which will impact allergists beginning in 20…
Need 2020 MIPS flexibility?
The Centers for Medicare and Medicaid Services (CMS) announced physicians have the option to opt-out completely or partially from the 2020 Merit-based Incentiv…
UnitedHealthcare to mandate electronic fund transfer payments
UnitedHealthcare (UHC) Insurance recently issued a new claims payment policy allowing for fast, easy reimbursement payments. The new policy will be phased in t…
2019 Open Payments Program Data Published by CMS
The Centers for Medicare and Medicaid Services (CMS) published the 2019 Open Payments Program data on June 30. Applicable manufacturers and Group Purchasing Or…
TRICARE denials of 95165
Over the past several weeks, the Advocacy Council has received reports from various parts of the country that TRICARE has been denying claims for CPT Code 9516…
