Industry Notes: MedPAC Proposes 1.2 Percent Payment Boost In 2009

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Note:  The following article synopsis was NOT provided by AAPC. It was created by Find-A-Code/innoviHealth.

Article Overview

This article is a Medicare and medical coding industry roundup for physicians, billing staff, and compliance professionals. It reviews proposed payment changes from MedPAC, mentions a CMS-related monitoring concept, highlights a Medicare reimbursement issue affecting oncology drugs, notes a telehealth modifier update for neurobehavioral status exams, references a state audit involving ASC billing practices, and points readers to reported corrections in CPT 2008.

Why This Topic Matters

The topic touches reimbursement, compliance, and code reporting issues that can affect practice revenue and claim accuracy. It is relevant to professionals who track Medicare policy updates, telehealth billing requirements, and annual CPT editorial corrections.

Article Sections

  1. MedPAC payment and monitoring proposal

    Discusses proposed Medicare payment updates and a related idea about monitoring physician resources used in care delivery.

  2. Medicare payment changes for oncology drugs

    Covers a reimbursement issue involving two oncology drugs and the financial impact described in the article.

  3. Telehealth billing update for neurobehavioral status exams

    Addresses a modifier-related billing update tied to services furnished through telecommunications systems and the settings referenced by the payer.

  4. Audit findings involving ASC claims

    Summarizes reported audit activity involving ambulatory surgery center claims and alleged improper cost waivers.

  5. CPT 2008 corrections

    Notes the release of editorial corrections to the CPT 2008 code set, including indexing and labeling fixes.

  6. Oxygen therapy reimbursement discussion

    Briefly references a news item about Medicare payment for home oxygen therapy and related supplier concerns.

What You Will Learn

  • Recent Medicare payment policy developments
  • A telehealth-related claim reporting update
  • The kinds of reimbursement and audit issues affecting providers
  • That CPT 2008 corrections were released and may affect reference accuracy
  • Broad Medicare oxygen therapy reimbursement concerns

Who Should Read This

  • Medical coders
  • Billing staff
  • Compliance professionals
  • Physician practices
  • Healthcare administrators

Codes Discussed

  • CPT: 96116
  • CPT: 43460
  • CPT: 32421
  • CPT: 32422

Modifiers Discussed

  • CPT: GT
  • CPT: GQ

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