2025 Endovascular & Interventional OBL vs ASC Fee Impact Analysis
In this blog we analyze the 2025 CMS Final Rule’s reimbursement impact on image-guided procedure specialists performing services in Office/OBL (POS 11) and ASC (POS 24) environments.
2025 MPFS: Key Updates on Telehealth and Frequency Limitations
The Centers for Medicare & Medicaid Services (CMS) has proposed significant updates for the 2025 Medicare Physician Fee Schedule (MPFS). Among the most noteworthy are the extensions of telehealth flexibilities and revisions to frequency limitations.
ASC Complexity Codes for Interventional Cardiac Cath Procedures
The following outline highlights the key aspects of Medicare coding and billing for procedures performed in ASCs, particularly focusing on the new complexity codes introduced in 2023 and their impact on 2024 billing.
Mammography Quality Standards Act (MQSA) – FDA Changes Effective 9/10/2024
On March 10, 2023, the FDA announced the final rule amending the MQSA regulations. Physicians and hospitals have had 18 months to adopt the FDA’s changes going into effect on September 10, 2024.
OIG Adds Lower Extremity Revascularization Procedures to 2025 Work Plan
The OIG will apply greater scrutiny to lower extremity revascularization procedures as part of its 2025 work plan
BCBS is Reducing Payment for E/M Service on the Same Day as Procedure
Recent payer policies will only reimburse 50% when an E/M and procedure are performed on the same day. Payers are now adding a layer of complexity by reducing the Evaluation and Management (E/M) service payment by 50% when a separately identifiable E/M service is provided in addition to the minor procedure performed. The use of […]
Help Improve Prior Authorizations
Prior authorizations are a significant administrative burden and the current process is cumbersome, inefficient, and costly, and ultimately delays radiology and interventional specialist patient care. Act now to help improve prior authorizations. Urge your Representatives and Senators to support the “Improving Seniors” Timely Access to Care Act of 2024″ (S. 4518/H.R. 8702). This bipartisan bill […]
Proper Nurse Visit Billing for Minimal Problems
AMA Definition – Minimal Problem Since 2021, the AMA definition of a “minimal problem” is a problem that may not require the presence of the provider. This type of visit is performed “incident-to” an established care plan and under the direct supervision of the physician or non-physician. Performance or supervision of these services typically takes […]
URGENT – Check Email for AMA Practice Expense Survey
The American Medical Association (AMA) contracted with Mathematica, an independent research company, to conduct the AMA Physician Practice Information Survey. Email recipients are not publicly known and the AMA will not disclose the recipients names. There are two elements to the PPI survey—a financial survey and a physician hours survey. Why This Survey is Important […]
Prevent Interventional Pain Denials and Improve Payments
StreamlineMD is here to provide interventional pain management documentation tips to prevent denials and improve payments. With continuous declines in physician payments, every detail counts. Update your report templates/macros. Ensure that your documentation is clear and concise, and consistent with CPT 2024 code language. Why Insurance Carriers Deny Claims: Insurance carriers’ business model is to […]