by RCM STI | Nov 13, 2024 | RCM Newsletter
CMS CY 2025 Physician Fee Schedule Final Rule Reminder CMS finalized a 2025 PFS Conversion Factor (CF) of $32.3465. The CY 2024 conversion factor is $33.29, the CY 2025 Conversion Factor will result in a decrease of 2.8% or $0.93. To make this information more...
by RCM STI | Oct 23, 2024 | RCM Newsletter
Influenza Vaccine: CMS Holding Claims for CPT Code 90658 From CMS: CMS is aware of an issue affecting payment for CPT code 90658: Long descriptor: Influenza virus vaccine, trivalent (IIV3), split virus, 0.5 mL dosage, for intramuscular use Short descriptor: IIV3...
by RCM STI | Sep 23, 2024 | RCM Newsletter
Annual Flu Vaccine Pricing from CMS From CMS: Part B payment allowance limits for seasonal influenza (flu) vaccines (that is, the vaccine product) are 95% of the Average Wholesale Price (AWP). In hospital outpatient departments, payment is based on reasonable...
by RCM STI | Aug 21, 2024 | RCM Newsletter
Medicare Physician Fee Schedule Proposed Rule for CY 2025 The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), proposed new policies in the calendar year (CY) 2025 Medicare Physician Fee Schedule (PFS)...
by RCM STI | Jul 21, 2024 | RCM Newsletter
CMS to Close Program that Addressed Medicare Funding Issues Resulting from Change Healthcare Cyber-Attack On June 17, 2024, CMS announced that payments under the Accelerated and Advance Payment Program for the Change Healthcare/Optum Payment Disruption (CHOPD) will...
by RCM STI | Jun 21, 2024 | RCM Newsletter
CPT 99459 Pelvic Examination Billing for Medicare CPT 99459 was added to CPT coding for 2024 as an add-on code service, which means that this code is only payable if provided and billed on the same day, on the same claim, as the appropriate service(s) allowed per...
