Starting Sept. 1, Aetna will pay 75% of the contracted rate for surgical procedures performed in urgent care facilities or independent clinics with or without modifier 54, used to indicate surgical care, according to a recent health plan update. Aetna says the change...
An article in Healthcare Finance News reports that, “The global health care sector experienced a staggering 1,613 cyberattacks per week in the first three quarters of 2023, nearly four times the global average, and a significant increase from the same period the...
For the fifth year in a row, the 2025 CMS Medicare Physician Fee Schedule (MPFS) forecasts a reduction in the Medicare conversion factor used to calculate physician payments, which at $32.36 represents a 2.80% payment decrease compared with 2024. In 2024, physicians...
Someone emailed me a very interesting question about MIPS performance. By way of background, the Merit Based Incentive Payment System (MIPS) consists of 4 weighted categories which this year are: Quality (30% of score), Cost (30% of score), Improvement Activities (15%...
Noridian and CGS Provider Outreach and Education have released the most frequently asked questions (FAQs) on lymphedema compression treatment items under the Lymphedema Treatment Act. An important thing to note is that if the patient has MLD services on a given date,...
