A rule aimed at protecting patients from surprise medical bills should stand now that the process it describes for settling payment disputes between providers and insurers aligns with Congress’ intent, the Biden administration told a federal court in Texas.
The stock price of R1 RCM tanked by roughly 50% this week after the large medical billing and collections company reported an unexpected $30 million loss in the third quarter.
The final 2023 Medicare physician fee schedule that CMS released Nov. 1 confirmed a harsh reality: Medical groups will see a 4.5% cut to the conversion factor (CF) on Jan. 1, 2023, as the CF falls to a rate of $33.06 and sends some charges under the Part B payment system tumbling.
The $33.06 CF rate comes in $1.55 less than the CY 2022 rate of $34.61. The anesthesia CF also will drop 4.4% in 2023, taking a cut from the CY 2022 rate of $21.56 to $20.61 in CY 2023, a reduction of $0.95 year over year.
Not all specialties will bear the brunt of the CF reduction equally, as CMS’ yearly effort at revising misvalued codes alters the contribution of relative value units (RVU) to the final payment picture. Final fees are a product of RVU inputs — practice expense, malpractice and work — multiplied by the CF.
Respiratory illnesses affect the lungs and other parts of the respiratory system (nose, mouth, pharynx, larynx, trachea, bronchi, and bronchioles). Deciphering documentation and assigning ICD-10-CM codes for these conditions requires a solid understanding of clinical indications, diagnostic classifications, and coding guidelines.
The number of specialties welcoming a boost to their allowed charges in 2023 is far outpaced by those facing projected cuts, according to relative value unit (RVU) revisions announced in the final 2023 Medicare physician fee schedule released Nov. 1.
A total of 11 specialties, led by diagnostic testing facility at +7% and infectious disease at +4%, are on track for an increase in charges based on the combined impact of work, practice expense and malpractice RVUs, according to an analysis of Table 148 in the final rule. In contrast, 36 specialties will face expected reductions to allowed charges due to slashed RVUs in at least one of the three categories.
As more hospital workers return to the office, the in-person meeting is back. After two years of virtual meetings, there are certain factors that need to be considered when meeting face-to-face. For example, room setup can affect a meeting in significant ways.