Expert Opinions

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.

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 […]

Clinical Diagnostic Laboratory Billing for COVID-19 Testing

We continue to monitor CMS updates for coding and billing information that will assist our client laboratories and other hospital laboratories to stay abreast of COVID-19 coding and billing during this public health emergency (PHE). CMS continues to expand billing and clarification for COVID-19 testing for clinical diagnostic laboratories.

UPDATE – Provider Telehealth Coding and Billing, effective April 1, 2020

CMS guidance for telehealth is changing rapidly. In an effort to continue providing coding and billing assistance to Panacea’s clients and the provider community during this public health emergency (PHE), we are updating the Telehealth coding and billing guidance for providers (physician, nurse practitioner, physician assistant) and have created a listing of eligible codes not […]