decisionhealth Newsletters, Part B News - 2019 Issue 8 (August)
Codes cleared with TCM in PFS have nowhere to go but up
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Article Overview
This article examines how the 2020 Medicare physician fee schedule addresses selected care management services that may be billed alongside transitional care management. It reviews prior utilization patterns, highlights services with notable changes over time, and discusses denial trends that may influence how the updated policies are received. The piece is aimed at coding, reimbursement, and practice management audiences following Medicare payment policy.
Why This Topic Matters
It helps readers understand which care management services are affected by the CMS policy change and why historical claim patterns may matter when evaluating future utilization.
Article Sections
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Benchmark of the week
A brief data-focused discussion of Medicare utilization trends for selected care management services over several years. The section places the 2020 physician fee schedule update in context with prior billing and denial patterns.
What You Will Learn
- How the 2020 Medicare physician fee schedule relates to selected care management services
- What historical utilization trends suggest about billing patterns for affected services
- Which broad categories of services saw notable changes in claims or denials over time
- Why prior payment policy changes may be relevant when evaluating future billing activity
Who Should Read This
- Medical coders
- Billing and reimbursement specialists
- Practice administrators
- Compliance staff
- Healthcare consultants
Codes Discussed
Code Ranges Discussed
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