If you have already registered with PECOS here is the documentation from CMS providing you with the List of Providers who are also registered in PECOS. It is important to remember that a provider you refer to must also be in PECOS or you risk having your claim denied by Medicare. This is working out to be very similar to the NPI transition a few years ago which everyone should remember with different phases and penalties. Will they ever stop changing things, I guess for the sake of our business we should hope not…
With all of the conversations about Health Care reform many practices have taken their eyes off of the current happenings in Medicare. 2010 will prove to be a year full of changes and could very well have bills signed that transform Medicare/Medicaid like never before.
One of the important changes is beginning January 1, 2010, Medicare will no longer accept consultation codes. Citing years of billing confusion related to the billing of consultation codes, CMS will require providers to bill all evaluation and management (E/M) services using the appropriate inpatient or outpatient visit codes. The change is expected to be budget neutral because the money spent on consults will be used to increase payment for new and established E/M services. However, many specialists who heavily bill consults will likely see a decrease in E/M reimbursement in 2010.
We have been awaiting news for this year’s fee schedule revision with Medicare and have the following information to share. Please note: Medicare has requested a reduction in payments for the last 4 years and congress has always (so far) intervened; however, the rate reductions has never been above 10%. If they remove the physician administered drugs, the RVU calculations used for determining time/supplies will increase value (up the fee schedule rate the reduction will come from). We will keep you updated with any additional information as we receive it.
CMS Proposes 21.5% Cut in Medicare Doc Payments
What do the new Medicare retroactive billing guidelines mean for hospitalists and new practices. Medicare is always the most convaluted aspect of credentialing because of the red tape and time required to credential a new physician or group. It is important that you understand how important it is that you have experts complete your applications because it could cost you thousands of dollars in missed opportunities to bill for services or in denied claims.
Here is an article from the AMA:
Medicare Enrollment Process
