decisionhealth Newsletters, Part B News - 2018 Issue 1 (January)
NPPs, other lower-billing specialists see 99214 payments on the rise
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Article Overview
This article examines Medicare claims data showing how utilization and payments changed over time for a commonly reported office/outpatient evaluation and management service. It focuses on patterns across non-physician practitioners and several physician specialties, highlighting which groups drove growth and how payment totals shifted between 2014 and 2016. The piece is relevant to coders, revenue cycle professionals, and specialty practices that track E/M reporting trends and payer mix.
Why This Topic Matters
Understanding which provider groups and specialties are associated with rising or falling claims volume helps practices monitor reimbursement trends, benchmark reporting patterns, and anticipate changes in E/M revenue.
Article Sections
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Claims and payment trends by specialty
This section summarizes multi-year Medicare claims and payment trends for the service code discussed in the article. It compares changes across provider categories and major specialties.
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Reimbursement by specialty, 2014 to 2016
This section presents a year-over-year view of payment patterns across specialties and provider groups. It focuses on how totals changed over the review period.
What You Will Learn
- How the article frames multi-year Medicare claims trends for a high-volume E/M service
- Which provider categories are highlighted in the payment analysis
- How specialty-level reporting patterns are compared over time
- Why the article is relevant to practices monitoring E/M reimbursement trends
Who Should Read This
- Medical coders
- Coding auditors
- Revenue cycle staff
- Practice administrators
- Specialty practice managers
- Physician billing teams
Codes Discussed
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