mEDICAL CODING CHANGES IN AND BEYONDJAN 2020 12 comments
CMS in 2020Principal care management (PCM) category was created for chronic care management services for managing only one complex condition, with two temporary codes currently G2064 and G2065 describing these services. CMS is finalizing these new codes with a higher Relative Value Unit (RVU) than originally proposed, which should give a somewhat higher rate of payment when implemented. For CY 2020’s proposed rule, CMS proposed increasing payments connected to CPT codes describing comprehensive care management services (CCM). Since then, all proposed increased payment updates have in fact been finalized, including CPT codes for transitional care management (TCM) and advanced care planning (ACP). CMS also finalized the proposal lifting billing restrictions that pertained to chronic care management CPT codes, and which was supported by those commenting. CMS believes that increasing these flexibilities will improve access to care management services. CMS is finalizing (temporary) code GCCC2 reflecting non-clinical staff time for CCM, with the proposed code now referred to as G2058, and which may be used two times per beneficiary within the service period. CPT codes 99487 and 99489 will continue to be used pending AMA’s further review of these services.
AMA, physician groups defend ACA gains in new Supreme Court filing
R Redefining Patient Collections in the Wake of the COVID-19 Crisis
The COVID-19 crisis is transforming patient collections, requiring providers to deliver a transparent, compassionate financial experience as patients weigh coming back and demand ramps back up.
Coronavirus (COVID-19) stay up to date Adapting Medicare Advantage bidding for COVID-19 related uncertainty on claims: A proposalhe Covid-19 pandemic is fundamentally disrupting the health care system and injecting significant uncertainty about current and future utilization and costs. Medicare Advantage (MA) plans serve over 35 percent of Medicare beneficiaries, and elderly individuals appear particularly susceptible to the contagion. Despite being in the early stages of the pandemic, MA plans are currently making financial decisions about costs, premiums, and benefits for 2021. MA plans and standalone prescription drug plans (PDPs) must submit their bids for the benefit year starting on January 1, 2021 on June 1, 2020. Submitting bids in June provides the lead time needed for the annual October 15, 2020 to December 7, 2020 “open enrollment” period when Medicare beneficiaries choose their preferred coverage option. https://www.brookings.edu/blog/usc-brookings-schaeffer-on-health-policy/2020/05/18/adapting-medicare-advantage-bidding-for-covid-19-related-uncertainty-on-claims-a-proposal/