Medical practices are assessing the impact of the change in the HCC model from V24 to V28, a phased in change that begins in 2024. CMS pays … [Read more...]
Nicoletti Notes
This way for news!
Written for coders and medical professionals, Nicoletti Notes is a coding blog designed to keep you up-to-date with coding news and refreshers. Written by CodingIntel founder and coding expert Betsy Nicoletti.
CMS’s 2024 shared or split services policy: document and report them correctly
In 2024, CPT expanded its definition of split/shared services, CMS updated their requirements. Updated video coming soon! CPT expanded its … [Read more...]
Facility versus Non-Facility in the Physician Fee Schedule
Understanding facility versus non-facility in the physician fee schedule explains the RVU and payment differences that practices receive when … [Read more...]
HCPCS Code G0136 for Assessment Social Determinants of Health (SDoH)
This is information from the 2024 Physician Fee Schedule Final Rule, released Nov. 2, 2023. New CPT and HCPCS codes, and CMS policy changes are … [Read more...]
CMS Adopts HCPCS codes for Community Health Integration (CHI) services
This is information from the 2024 Physician Fee Schedule Final Rule https://public-inspection.federalregister.gov/2023-14624.pdf The effective … [Read more...]
CMS finalizing Principal Illness Navigation (PIN) services
This is information from the 2024 Physician Fee Schedule Final … [Read more...]
CMS Adopts Codes for Caregiver Training Services (CTS)
This is information from the 2024 Physician Fee Schedule Final Rule, published Nov. 2, 2023. You can read it for yourself by downloading the pdf … [Read more...]
Medicare coverage for Marriage and Family Therapists and Mental Health Counselors
In the Consolidated Appropriations Act, 2023 Congress mandated that Medicare provide coverage and payment for the services of health professionals who … [Read more...]
Coding for telehealth – Overview
Update: Medicare telehealth payment policies The public health emergency federal designation expired March 11, 2023 However, the end of the … [Read more...]
What’s New in the Proposed Physician Fee Schedule Rule
Proposed Physician Fee Schedule Rule, 2024 CMS issued the Proposed Physician Fee Schedule (PFS) Rule July 13, 2023, with a 60-day comment period. … [Read more...]
Coding Clinic Update, 2Q, 2023
Dr. Kennedy has generously allowed me to share his summary. He emphasizes that he is paraphrasing the recent advice in the spirit of “fair use” and we … [Read more...]
2023 CPT® E/M Changes
Ready to learn about the 2023 CPT® E/M changes? There is a significant update to the Evaluation and Management (E/M) section of the CPT® book. There … [Read more...]
Payment denials for unspecified codes
From the day coders got their first glimpse at ICD-10 codes, the question went out in the land: “Will payers deny unspecified codes?” Recently, a … [Read more...]
Behavioral health coding compliance
Once again, with feeling: coding for behavioral health It's been a year (seems like a minute) since the OIG released a report on coding for … [Read more...]
How old is your oldest CPT book
My, how CPT® has grown Thank you to everyone who completed our mission critical survey: how old is your oldest CPT® book and how many pages is it? … [Read more...]
2023 RVU table with national fee amounts
Looking for 2023 work RVUs? Wondering how much a new code pays? Look no farther. You can download the 2023 CMS national RVU table below. It does … [Read more...]
Physician Fee Schedule Final Rule for Calendar Year 2023
2023 conversion factor $33.8872 (updated 1/5/2023) CMS continues to state it doesn't have the authority to extend telehealth in all geographic … [Read more...]
Why not bill all 99213 visits in an FQHC?
Why not bill all 99213 visits in an FQHC? (Hint: it's a good way of telling everyone that they were pretty easy visits.) Practitioners who work in … [Read more...]
Consultation Codes Update
Consultation Codes Update, October 2022: The CPT books have arrived! Finally. And, with it, there is a consultation codes update for 2023. First, … [Read more...]
Medicare “Audio-Only” Telehealth Services
CMS issued multiple waivers and two interim final rules to support health care organizations and patients during the public health emergency in spring … [Read more...]
Coding Telehealth Visits: place of service
Information in this article was updated July 2023, based on the 2024 Proposed Physician Fee Schedule Rule. Coding telehealth visits changes faster … [Read more...]