APCM vs. CCM: what every primary care practice needs to know before switching; rates, rules, revenue impact, and who ...

CMS suggests 1,495 total changes to the ICD-10-CM diagnosis code set in the FY 2023 IPPS proposed rule. Brain illness and injury, with a focus on dementia-related diagnoses, occupy a high volume of ...

CVS Health (CVS) stock is down as its insurance unit Aetna to pay $117.7M to settle DOJ's Medicare Advantage fraud allegations over diagnosis codes. Read more here.

395 new diagnosis codes have been proposed by CMS for fiscal year 2024. CMS recently released the fiscal year 2024 inpatient prospective payment system proposed rule, and with it came the annual ...

CMS released its Medicare payment codes for administering an antibody treatment found effective against the COVID-19 omicron variant. The payment codes, effective Feb. 11, are for bebtelovimab. The ...

For many years, primary care providers had no direct or explicit mechanism to be reimbursed for services specifically provided to Medicare and Medicaid beneficiaries under the collaborative care model ...

Medical professionals and healthcare facilities must complete different forms when billing for the services they provide. These are not forms you need to complete yourself. Claim form CMS-1500 is for ...

In January, the Centers for Medicare and Medicaid Services announced that it would cover continuous glucose monitoring for the first time; specifically it would cover therapeutic CGMs, of which the ...

A new JAMA study shows that a new Medicare billing code may have benefited specialists more than the primary care physicians it was designed to help most.

Medicare allegedly paid 15M for ED services billed at nonemergency sites, prompting OIG findings and CMS response on improper payments.