The Biden Administration is ending the COVID19 Public Health Emergency May 11, 2023. This blog is intended to assist you with that transition which includes important coding and billing items that will change because of the end of the PHE. Even if you believe that you are no longer involved in the treatment of or diagnostics for COVID, if you are doing any kind of remote patient care, laboratory, or Telemedicine then you will need this information moving forward. It is hard for a medical provider to be Medical Billing Experts on all relevant topics. ClaimCare is here to help.  ClaimCare M ..read more

For COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies and other immunizers will be $40 per dose. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines, and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is ..read more

On February 26, 2021, the Centers for Medicare & Medicaid Services (CMS), together with the Department of Labor and Department of the Treasury, issued new GUIDANCE that removes barriers to COVID-19 diagnostic testing and vaccinations, and strengthens requirements that plans and issuers cover diagnostic testing without cost sharing. This CMS guidance raises some key points and a few questions that need to be inspected by Healthcare Compliance Attorneys of providers/organizations involved with testing and vaccinations. With this blog post we are providing further details about the CMS guida ..read more

For COVID-19 vaccines administered on or after March 15, 2021, the national average payment rate for physicians, hospitals, pharmacies and other immunizers will be $40 per dose. This represents an increase from approximately $28 to $40 for the administration of single-dose vaccines, and an increase from approximately $45 to $80 for the administration of COVID-19 vaccines requiring two doses. The exact payment rate for administration of each dose of a COVID-19 vaccine will depend on the type of entity that furnishes the service and will be geographically adjusted based on where the service is ..read more

On February 26, 2021, the Centers for Medicare & Medicaid Services (CMS), together with the Department of Labor and Department of the Treasury, issued new GUIDANCE that removes barriers to COVID-19 diagnostic testing and vaccinations, and strengthens requirements that plans and issuers cover diagnostic testing without cost sharing. This CMS guidance raises some key points and a few questions that need to be inspected by Healthcare Compliance Attorneys of providers/organizations involved with testing and vaccinations. With this blog post we are providing further details about the CMS guida ..read more

CMS Seeks Faster COVID-19 Lab Results CMS is working to ensure that patients who test positive for the virus are alerted quickly so they can self-isolate and receive medical treatment. Thus, under President Trump’s leadership, the Centers for Medicare & Medicaid Services posted an October 15 announcement of new actions to pay for expedited COVID-19 test results. Back on April 15, CMS Administrator Seema Verma announced, “CMS has made a critical move to ensure adequate reimbursement for advanced technology that can process a large volume of COVID-19 tests rapidly and accurately.” At that t ..read more

Just in case you are not already aware, this memo is to inform you the American Medical Association (AMA) added Current Procedural Terminology (CPT) code 99072, effective September 8, 2020, and has updated information about this code and other codes, which was posted September 22, 2020, on the AMA website in an article titled COVID-19 Coding and Guidance. Coming rather late in the COVID-19 crisis, this code regards “Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service when performed during a Public Healt ..read more

A trend began several years ago for practices to move billing and coding offshore to save money, which has often led to crippling the practices rather than adding any advantage in terms of being more effective, efficient and productive. And money has often been lost rather than saved. A January 2019 “For The Record” article titled Is Offshore Coding Dead in the Water? tells of a two-year study involving six hospital systems. In an apples-to-apples comparison of USA coders and offshore coders, the offshore coders were less accurate and productive than the USA coders. There was a higher denial ..read more

Provider Relief Fund Deadline Extended to August 3 It’s not too late to apply for financial emergency assistance from the Provider Relief Fund if you have not yet done so. The deadline to apply has been extended to Monday, August 3. For in-depth information from HHS about this extension, visit CARES Act. Included with the latest update on the application process is information about a webcast on Monday, July 27, 2020 at 3:00 p.m. ET.     You may also want to revisit an earlier ClaimCare blog concerning Four Options to Boost Your Practice’s Cash on Hand Balance.   Anot ..read more

We are posting this blog for ClaimCare clients and for other medical practices and facilities who have not yet become clients. During this continuing COVID-19 pandemic, we want to proactively explain to all in the healthcare industry why your Account Receivables may be behaving differently than anyone would expect. In a previous blog I shared how ClaimCare spent significant time, energy and money putting in place a fully-tested, HIPAA-compliant work-from-home option several years ago following a flu season that hit ClaimCare and the nation hard.  Thus, we are one of the relatively few com ..read more