decisionhealth Newsletters, Coder Pink Sheets - 2021 Issue 9 (September)
Rules & regulations: Check the math on proposed values for your top codes
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Article Overview
This piece explains how CMS’ proposed physician fee schedule changes may affect office-based evaluation and procedure services commonly reported by pain management and interventional pain management practices. It focuses on relative value unit updates, projected non-facility payment effects, and why proposed adjustments can offset or intensify the impact of the conversion factor change. The article is useful for practices reviewing their highest-volume services, coding and reimbursement staff, and anyone tracking Medicare payment proposals for the coming year.
Why This Topic Matters
Proposed RVU and payment changes can materially affect office-based Medicare revenue for high-volume services. Reviewing the top reported codes helps practices anticipate budget impact and evaluate the proposed fee schedule before it is finalized.
Article Sections
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Proposed fee schedule impact for top services
An overview of the proposed Medicare physician fee schedule changes and how the analysis is structured for commonly reported office-based services in pain management specialties.
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Resource and source data
A brief reference to the CMS addendum and the utilization data used for the analysis.
What You Will Learn
- How the article frames proposed Medicare payment changes for office-based services
- Which specialties and service categories are the focus of the analysis
- What kinds of fee schedule inputs are compared in the article
- How the source data and CMS proposal are used to evaluate payment impact
Who Should Read This
- Medical coders
- Coding auditors
- Practice managers
- Revenue cycle staff
- Pain management practices
- Interventional pain management practices
Codes Discussed
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