decisionhealth Newsletters, Coder Pink Sheets - 2015 Issue 12 (December)
Final physician fee schedule: Conversion factor, policy changes and more from final 2016 physician fee schedule
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Article Overview
This article reviews several 2016 Medicare physician fee schedule developments that affect physician practices, anesthesia services, outpatient therapy, colorectal cancer screening billing, and diagnostic imaging. It is aimed at coders, billers, and practice staff who need a high-level view of policy changes and the related coding concepts discussed in the final rule. The coverage includes payment factor adjustments, therapy cap thresholds and exceptions, a deductible-related clarification for screening procedures, and a new imaging modifier tied to equipment compliance.
Why This Topic Matters
These updates can affect reimbursement, claim handling, and compliance planning across multiple specialties. The article helps readers track which Medicare policy changes may require workflow or billing adjustments for 2016 and beyond.
Article Sections
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Conversion factor updates
Discusses changes in Medicare physician and anesthesia payment conversion factors for 2016 and the policy adjustments underlying those changes.
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Three more changes to note
Summarizes additional Medicare policy updates affecting colorectal screening billing, outpatient therapy caps and exceptions, and diagnostic imaging claims.
What You Will Learn
- How the 2016 physician fee schedule article frames major Medicare payment updates
- Which policy areas were highlighted as especially relevant to physician, anesthesia, therapy, and imaging billing
- What general kinds of claim-processing and compliance changes were described in the final rule coverage
- How the article organizes its discussion of Medicare fee schedule changes for practice use
Who Should Read This
- Medical coders
- Medical billers
- Compliance staff
- Physician practice administrators
- Anesthesia billing staff
- Therapy clinic staff
- Radiology billing staff
Modifiers Discussed
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