Tag Archive for ‘physician reimbursement’

David B. Hoyt, MD, FACS

Looking forward – February 2021

This column provides a timeline of the events that led to the passage of the Omnibus Consolidated Appropriations Act of 2021, which directs the Centers for Medicare & Medicaid Services to postpone plans to eliminate payment for non-office-based evaluation and management services.

2021 Medicare physician fee schedule: How will it affect your practice?

Editor’s note: This article was posted electronically with the January Bulletin so that surgeons would have access to the important information it provides regarding changes in Medicare payment that took effect that month. Because of delays in the release of the final rule on the updates, this information was unavailable when the print version of […]

Price and cost: Both are important to achieve value-based care

HIGHLIGHTS Explains the difference between price and cost Describes methods for measuring both variables Underscores their importance in value-based payment model design Highlights ACS THRIVE Insurers increasingly tell surgeons that they need to reduce costs as health care grows unaffordable for a growing proportion of Americans. Similarly, hospital administrators frequently challenge surgeons to reduce their costs, […]

David B. Hoyt, MD, FACS

Looking forward – January 2021

The College’s initiatives to address the challenges of 2020, including the coronavirus 2019 (COVID-19) pandemic and Medicare reimbursement cuts, as well as efforts to promote and ensure diversity, equity, and inclusion in all ACS-related activities, are summarized.

ONLINE FIRST: 2021 Medicare physician fee schedule: How will it affect your practice?

Editor’s note: This article is being posted electronically with the January Bulletin so that surgeons will have access to the important information it provides regarding changes in Medicare payment that took effect this month. Because of delays in the release of the final rule on the updates, this information was unavailable when the print version […]

The 2020 Medicare physician fee schedule

The 2020 Medicare physician fee schedule: An overview of provisions that will affect surgical practices

This article reviews provisions in the 2020 Medicare physician fee schedule final rule that are relevant to general surgery and its related specialties.

Table 1. PAR and non-PAR reimbursement

Medicare enrollment and participation

This article provides guidance to assist Fellows in navigating their contractual relationships with the Centers for Medicare & Medicaid Services.

Medicare physician payment on the decline: It’s not your imagination

Medicare physician payment on the decline: It’s not your imagination

Congressional attempts to control Medicare physician spending through anti-inflationary policies are highlighted as are the future of Medicare payment updates under MACRA.

Dateline DC

Dateline DC: CMS releases two proposed payment rules

A summary of 2020 Medicare Physician Fee Schedule and Outpatient Prospective Payment System/Ambulatory Surgery Center proposed rule policies that could affect physician payment is provided.

Redefining surgical value in the Quality Payment Program

Redefining surgical value in the Quality Payment Program

Describes the College’s efforts to work with Congress and the Centers for Medicare & Medicaid Services to develop meaningful measures of surgical quality in the Quality Payment Program.

Coding and Practice Management

Modifier 51 or 59? How to correctly report multiple procedures

The correct use of modifiers 51 and 59 are explained, including case examples featuring clinical scenarios with correct coding.

2019 Medicare physician fee schedule

The 2019 Medicare physician fee schedule: An overview of provisions that will affect surgical practices

This article summarizes provisions in the 2019 Medicare physician fee schedule final rule that are relevant to general surgery and its related specialties.

What Surgeons Should Know About...

Medicare participation and enrollment

Physicians, nonphysician practitioners, and other Medicare Part B providers must enroll in the Medicare program to be paid for the covered services and items they provide to Medicare beneficiaries. Providers must make their 2019 Medicare determinations by December 31. As the deadline approaches and providers consider their options with respect to Medicare participation, this column […]

What Surgeons Should Know About...

Qualified Medicare Beneficiary program billing requirements

The restrictions regarding physicians’ ability to seek reimbursement for cost-sharing amounts from Qualified Medicare Beneficiary (QMB) enrollees are summarized as are practices to ensure compliance with QMB billing rules.

What Surgeons Should Know About...

The 2018 inpatient-only list

Provides an update on the Medicare inpatient-only list—which refers to procedures identified by CMS as typically provided in the inpatient setting and therefore not paid under OPPS—is provided.

Surgeons in the OR

Regulatory burden reduction

This column provides an overview of efforts to reduce regulatory burdens on surgeons, looks at the regulations that are most onerous for surgeons, and describes ACS recommendation for reducing or eliminating these encumbrances.

The 2018 Medicare physician fee schedule: An overview of provisions that will affect surgical practices

This article summarizes provisions in the 2018 Medicare physician fee schedule final rule that are relevant to general surgery and its related specialties.

Medicare participation: Know your options

The three options for surgeons who participate in Medicare Part B are summarized, as are the steps for achieving participating in this program.

What Surgeons Should Know...

The New Medicare Card Project

The steps providers can take to prepare for the Centers for Medicare and Medicaid Services New Medicare Card Project are outlined.

Table 6

2016 ACS Governors Survey: Issues affecting surgical practice

Surgeons’ views on health policy and advocacy-related issues and their potential effect on general surgery practice, based on the findings of the 2016 ACS Governors Survey, are summarized.

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