Part B Update: Despite CPT® Revision, Medicare Won't Update 'New Patient' E/M Rules for 2012

Why This Topic Matters

The article helps practices understand where Medicare policy does and does not align with CPT changes, verify whether older claims were corrected, and monitor payment adjustments that can affect Part B reimbursement.

Article Sections

1. Background

   This section introduces the CPT update and the broader Medicare response discussed in the article. It also addresses how CMS distinguishes patient status for Part B processing and related specialty considerations.

2. Keep in mind

   This section provides additional Medicare context on specialty recognition, enrollment information, and how practitioners can confirm their billing status. It also notes the agency’s position on system capabilities related to specialty and subspecialty distinctions.

3. Claims Reprocessing Finally Completed

   This section covers the completion of a large CMS claims reprocessing initiative tied to prior payment changes. It explains why practices should review accounts receivable for any outstanding adjustments.

4. E-Prescribing Penalties Kicked In

   This section summarizes the start of e-prescribing-related payment adjustments for Medicare Part B and references the period affected. It also notes the need for practices to review remittance information and monitor compliance-related activity.