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Outpatient Facility Fees
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Inpatient MS-DRG FY 2020 v3.26
How to Use the Searchable MPFS
How to use the Searchable Medicare Physician Fee Schedule (MPFS)
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December 8th, 2020
Final Rule on Communications Technology and 2021 Physicians Fee Schedule
Published December 8th, 2020|
To create a healthcare system that will benefit providers as well as Medicare beneficiaries there have been several new rules issued that begin on or after January 01, 2021. CMS released the final policy and payment provisions on December 01, 2020, which includes the physician fee schedule (PFS) for 2021. ...
September 23rd, 2020
My Location and CBSA is Missing!
Published September 23rd, 2020|
We often get questions on missing Core Based Statistical Areas, known as CBSAs. CBSAs are used for pricing and other factors according to the geographical location. If you do not see your CBSA, it is important to note they are not missing - it may not have an assignment, according to ...
August 7th, 2020
Impact of 2021 Proposed Medicare Fee Schedule on Chiropractic Offices
Published August 7th, 2020|
On August 3, 2020, the proposed Medicare Physician Fee Schedule for 2021 was released. This 1,355 page document includes some sweeping changes to the Medicare program. There are a few items in particular which should be noted by chiropractic offices.
July 9th, 2020
Payment Adjustment Rules for Multiple Procedures and CCI Edits
Published July 9th, 2020|
Surgical and medical services often include work that is required to be done prior to a procedure and post-procedure. When there are multiple procedures done by the same physician, group, or another qualified healthcare professional on the same day, the pre and post work is only required once. Therefore, CMS ...
July 1st, 2020
Understanding UCR Inpatient Fees used on DRGs
Published July 1st, 2020|
June 15th, 2020
Outpatient Facility Pricing
Published June 15th, 2020|
Our newest feature launch offers UCR pricing for Outpatient Facility. We recently released pricing information based on databases of insurance claims from private-sector health care providers.Usual, customary, and reasonable charges (UCR) are medical fees used when there are no contractual pricing agreements and are used by certain healthcare plans and third-party payers to generate ...
March 30th, 2020
Spotlight: UCR Fees are Available on DRGs- Check it Out!
Published March 30th, 2020|
Check out the information page on any DRG! Look up DRGs by going to the list of DRG codes found under the Codes tab at the top of the page, or simply type in the desired DRG by using the search bar on the homepage. When using the search bar, be sure you have the ...
December 4th, 2019
Preview the PDGM Calculator (HIPPS calculator) for Home Health Today
Published December 4th, 2019|
Find-A-Code's Patient-Driven Groupings Model (PDGM) home health payment calculator (HIPPS Calculator) simplifies payment calculations. See https://www.findacode.com/tools/home-health/ .
November 25th, 2019
New Medicare Home Health Care Payment Grouper — Are You Ready?
Published November 25th, 2019|
In 2020, Medicare will begin using a new Patient-Driven Groupings Model (PDGM) for calculating Medicare payment for home health care services. This is probably the biggest change to affect home health care since 2000.
November 20th, 2019
VA: How UCR Charges are Determined
Published November 20th, 2019|
How does the VA determine charges billed to third party payers for Veterans with private health insurance? According to the VA. "38 C.F.R 17.101 stipulates the basic methodology by which VA bills third party insurance carriers. In order to generate a charge for medical services, VA establishes reasonable charges for five ...
November 11th, 2019
And Then There Were Fees...
Published November 11th, 2019|
Find-A-Code offers fees and pricing for just about everything, this article will address two of some of the most common payment systems with CMS. (OPPS) -Outpatient Medicare Outpatient Prospective Payment System. (MPFS)- Medicare Physician Fee Schedule The Fees section on each code page is determined on the type of services...
October 21st, 2019
VA- Reasonable Charges Rules, Notices, & Federal Register
Published October 21st, 2019|
August 21st, 2019
So How Do I Get Paid for This? APC, OPPS, IPPS, DRG?
Published August 21st, 2019|
You know how to find a procedure code and you may even know how to do the procedure, but where does the reimbursement come from? It seems to be a mystery to many of us, so let's clear up some common confusion and review some of the main reimbursement systems. One of the ...
April 1st, 2019
Spinal Cord Stimulator Used for Chronic Pain
Published April 1st, 2019|
Chronic pain is a condition that can be diagnosed on its own or diagnosed as a part of another condition. When coding chronic pain, there is no time frame defining when pain becomes chronic pain; the provider’s documentation should be used to guide the use of these codes. ICD-10-CM Diagnosis Codes ...
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October 30th, 2018
Skyrocket Cash Collections, Even When Patients Have High Deductibles and Copays
Are you seeing $5,000, $7,500, and even $10,000 deductibles? We're hearing doctors from every state tell us they can't believe how high patients' insurance deductibles are getting. Some are even reporting patient copays of $50 - $60. (That's more than most docs charge for their adjustment!) When accepting insurance, do you know that you CAN'T discount services that apply to these large deductibles? And you can't treat them as "cash" patients. There is a way to overcome this problem of rising deductibles & copays and collect more cash - all while still accepting insurance. This one strategy alone will help you increase your case acceptance, even when patients have $10,000 deductibles. Join Dr. Miles Bodzin for this information-packed presentation. If you're going to be able to serve your communities and sleep well at night, you need this information.
June 29th, 2017
How to Convert Your Medicare Patients to Cash to Avoid the Penalties of MACRA
The #1 concern reported by CMS about chiropractors is that, as a profession, we do a poor job of understanding maintenance care. Of course, that is THEIR definition of maintenance care. When you better understand the rules of medical necessity in Medicare, you begin to see what they are talking about. The truth is that there is a “gray” area between the distinct “white” of active treatment and the “black” of maintenance treatment, and that gray area is confusing when defining “covered” vs. “not covered” chiropractic care in Medicare. Join us to find out the following critical information in time for the MACRA Section 514 implementation January 1, 2017: Find out exactly what Medicare deems as maintenance care and how to recognize it with our patients Learn what your options are for treating your Medicare patient’s maintenance care for cash Hear scripting that is vital to your patient understanding what’s going on with their coverage, or lack thereof Properly document the difference between active and maintenance care Better manage those little incidents that come up for chronic, Medicare patients
Assistant Surgery ModifiersAWP, WAC, ASP, APC ExplainedCenters for Medicare & Medicaid Services Patient-Driven Groupings ModelFair HealthHome Health Billing FAQsPhysician Payment WebsiteTop 10 Chiropractic Fee Questions: How Much Can I Charge?
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