The Devil’s in the Details of the New Hospital Price Transparency Rules

Raising sufficient general awareness of the new federal hospital price transparency rules set to take effect in just a little more than three months isn’t so much an issue anymore – industry leaders have been sounding alarm bells for much of the year, and even members of the public at large became well aware of […]

What Radiology Practices Need to Know About Medicare’s Prior-Authorization Requirements

Beginning July 1, Medicare will require prior authorization for five procedure classes: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation. As a reminder, prior authorization was announced through the Calendar Year 2020 Outpatient Prospective Payment System/Ambulatory Surgical Center Final Rule (CMS-1717-FC).

Hospital Zero-Base Pricing® A Novel Approach to Establishing Rational Chargemaster Prices

Can You Document and Defend Your Chargemaster Prices Under the 2020 CMS Final Rule?   

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Relaxing Rules for Telehealth

I’m sure everyone has heard the saying“the only constant is change.” Well, it certainly rings true these days. The Centers for Medicare & Medicaid Services (CMS) issued a second interim final rule on April 30, offering another round of coding and documentation updates related to telehealth during the public health emergency.

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Coding and Billing Resources for Coronavirus (COVID-19)

Coding and Billing Resources for Coronavirus COVID-19 Important information that provides current coding and billing updates from all of the regulatory agencies for our clients and the provider community during this public health emergency (PHE). We will continue to update this page as new guidance is received and reviewed by our senior healthcare consultants.

CMS and AMA payment and coding updates, effective July, 1 2020

Panacea has summarized the Centers for Medicare and Medicaid Services (CMS) and American Medical Association (AMA) payment and coding updates, effective July 2020 (with some retroactive changes). Please review the updates for possible implementation in your hospital chargemaster and/or review by applicable department, coding and billing staff.

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E&M Changes: How Will They Affect Your Practice?

As many of you have heard, there are major changes coming to evaluation and management (E&M) codes in 2021. The changes were finalized in the 2020 Physician Final Rule.

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Modifications to Hospital Outpatient Services During COVID PHE

Telehealth Expansion for Hospitals CMS is increasing access to telehealth for Medicare patients. What this means for hospitals is they will be permitted to code and bill during the PHE for services to which allowed physicians and practitioners employed by the hospital perform a face-to-face visit via telehealth service for a registered outpatient of the […]

UPDATE: COVID-19 Telehealth, Telemedicine and Physician Supervision Rules

In response to the comments received from the CMS-1744-IFC issued March 26, 2020, there are several updates related to Telehealth and/or Telemedicine and the Physician Supervision Rules.

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UPDATE: COVID-19 Antibody & Antigen Testing

In the CMS-5531-IFC dated April 30, 2020, CMS has stated COVID-19 serology antibody testing will be coverable by the Medicare program because they fall under at least one Medicare benefit category. The serology test that detects antibodies to SARS-CoV-2, the virus that causes COVD-19, may potentially aid in identifying patients who have had an immune […]

UPDATE: COVID-19 Specimen Collection for Hospitals & Physicians

In the CMS-5531-IFC Dated April 30, 2020, CMS confirmed new guidance for specimen collection services and payment. It is important for hospitals and physicians to review the applicable coding guidance summarized below and implement use for claims reporting as soon as possible. Hospital Outpatient CMS is creating a new E/M code to support COVID-19 testing […]