tci Medicare Compliance & Reimbursement - 2006 Issue 22
REIMBURSEMENT: New Rule Could Boost RVUs For E/M Codes At Surgical Procedures' Expense
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Article Overview
This Find-A-Code article summarizes upcoming Medicare reimbursement policy changes discussed by CMS officials, including a proposed rule on practice expense calculations and the five-year review of relative value units. It also covers operational guidance for physical therapy claims, documentation scrutiny tied to an HHS Office of Inspector General report, and expected changes affecting ambulatory surgery center billing. The content is relevant to coders, billers, compliance staff, and physician practices tracking payment updates and claim-edit issues.
Why This Topic Matters
The article helps readers understand policy shifts that may affect reimbursement, claim handling, and billing workflows across physician practices, physical therapy services, and ambulatory surgery centers.
What You Will Learn
- What CMS is planning in a forthcoming proposed rule
- How RVU review is expected to affect broader reimbursement patterns
- What issue is affecting physical therapy claim processing
- Why documentation review is receiving increased scrutiny
- How ambulatory surgery center payment changes are expected to evolve
Who Should Read This
- Medical coders
- Medical billers
- Practice managers
- Compliance staff
- Physician office administrators
- Physical therapy billing staff
Modifiers Discussed
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