The simplest solution is usually the best one. When it comes to the tangled web of Medicare services and billing, however, staying simple isn’t always easy. Every year, the Centers for Medicare & Medicaid Services (CMS) update their policies in order to stay on top of technological advances and to streamline their processes. Less paperwork means more time to focus on what matters most. Physicians, services providers, and any staff that handles billing must take note of these updates to make sure they are compliant for the upcoming calendar year. These changes, as well as other changes in payment coding, are outlined in the annual MLN Matters, released by the CMS.
Physicians and other providers who submit claims to Medicare Administrative Contractors (MACs) for services paid under the Medicare Physician Fee Schedule (MPFS) must pay special attention to this document, as it includes many important updates.
MLN Matters Updates Include:
Summary of Policies in the Calendar Year (CY) 2019
Medicare Physician Fee Schedule (MPFS) Final Rule
Telehealth Originating Site Facility Fee Payment Amount and
Telehealth Services List
CT Modifier Reduction List
Preventive Services List
In addition to the final rule on the fee schedule for 2019 that posted on November 1, 2018, one of CMS’ primary goals for 2019 is to simplify the compliance burden on healthcare providers. This includes streamlining documentation related to home visits, office visits, and outpatient visits. It also includes changes to payments, coding, and other documentation.
The key words for 2019 are simplicity and flexibility. Reduction in duplicative paperwork results in more time saved for practitioners. Flexibility in payment processing leads to a simpler process for beneficiaries. The CMS, overall, is enacting “policies (that) will allow practitioners greater flexibility to exercise clinical judgment in documentation, so they can focus on what is clinically relevant and medically necessary for the beneficiary.” Read the full document here.
Even though these updates are intended to simplify compliance, changes of any type are a challenge to implement. Small mistakes can have a dramatic effect on reimbursements and your revenue cycle. We recommend implementing a plan for implementing the updates described in MLN Matters immediately.
Do you have questions about how 2019 CMS updates affect your practice? Schedule a consultation today to assess your readiness and ensure compliance.