decisionhealth Newsletters, Coder Pink Sheets - 2015 Issue 12 (December)
Final fee schedule includes advance care planning and more
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Article Overview
This article reviews selected provisions from the final 2016 Medicare physician fee schedule. It focuses on advance care planning as a new payable service, a revised billing date-of-service policy for transitional care management, and broader payment changes affecting common evaluation, home visit, specialty, and preventive services. The piece is relevant to physician practices, billing staff, and coding professionals tracking Medicare updates.
Why This Topic Matters
The fee schedule changes affect how practices report and bill certain services, when claims may be submitted, and which services may see payment shifts in 2016. Coding and billing teams need this information to align documentation, claim timing, and revenue expectations with Medicare policy.
Article Sections
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Advance care planning in the final 2016 fee schedule
Covers the addition of a payable service category in the 2016 Medicare physician fee schedule and the general policy context around reporting and billing. It also notes the settings and visit types discussed in the rule.
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Follow new date-of-service rule for TCM billing
Explains that the article addresses a revised date-of-service policy for transitional care management and the timing of claim submission under the 2016 rule. It also places the change in the context of Medicare billing workflow.
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Conversion factor drops; payment fluctuates
Summarizes the article’s discussion of the 2016 Medicare conversion factor and examples of payment changes across selected common services. It also notes that the final fee schedule is part of the post-SGR payment environment.
What You Will Learn
- What major 2016 Medicare physician fee schedule updates are highlighted in the article
- How the article frames billing and reporting changes for advance care planning
- What the article says about revised timing for transitional care management claims
- Which broad categories of services are discussed as experiencing payment changes
- Why the fee schedule update matters for practice revenue and billing operations
Who Should Read This
- Physician practices
- Medical coders
- Medical billers
- Practice administrators
- Revenue cycle staff
- Compliance teams
Codes Discussed
Modifiers Discussed
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