ADVION’s Post

Important updates below!

Urgent Action Needed to Prevent Medicare Cuts to Physical Therapy Your voice is needed to stop Medicare cuts before the end of the year. The final 2024 Medicare Physician Fee Schedule rule recently released by the U.S. Centers for Medicare & Medicaid Services contains a 3.4% reduction to the conversion factor that will result in payment cuts to dozens of providers in 2024, including physical therapists. As it has for the past three years, Congress must once again intervene before the end of the year and provide additional funding to the 2024 fee schedule to mitigate the proposed cuts to providers. With dwindling legislative days, we need your action as soon as possible. Please take two minutes and send an email to your members of Congress urging them to stop the proposed 2024 cuts to the Medicare fee schedule. https://lnkd.in/exYyGKee Telfonix Medical Billing www.Telfonix.com

This is a well-deserved recognition of complexity of delivering #primarycare. People with health care needs that extend to specialist services face many hurdles: delays in access to specialist care, recommendations for care that may address a health condition but fail to integrate those recommendations into care that works for the person, and more. High-performing primary care includes coordination of care across the health care continuum - hard work that is not recognized or compensated in the fee-for-service environment. I'm very glad that #cms recognizes the worth of this work for #medicare . Why not for children with #medicaid? An unfortunate number of children & adolescents are experiencing more complex care needs with the increase in hypertension, obesity, diabetes, asthma and more. PCPs working with this population can use the help to better help the kids with needs. #G2211 for Medicaid would be a good next step.

Prior authorizations can be a very important tool as a check and balance to ensure that a patient is getting the most appropriate care at any particular time, but it can also be incredibly bureaucratic and burdensome for providers and patients. This adds administrative costs and potentially delays key treatments. There is no doubt the prior authorization process needs to evolve, and eliminating the process for primary care providers is a very logical step. Where do you believe the sweet spot is for maximizing the benefits of prior authorization while minimizing the added burden and costs?

Hey there, FHO & FHN physicians! Did you know that the Ministry has introduced an additional payment based on the acuity of patients enrolled? To ensure you're maximizing this increased capitation opportunity, accurate diagnostic code reporting in your claims is crucial. We have you covered with a handy guide that answers your most common questions on the new acuity update and provides helpful tips on using diagnostic codes accurately. Download our guide now and stay ahead of your billing! https://loom.ly/KC2SBfE #ontariophysicians #medicalbilling #diagnosticcodes #healthcareupdates

📑 Updated Medicare Fee Schedule: Advances and Setbacks The 2025 Medicare Physician Fee Schedule (MPFS) proposes a complex mix of changes, including significant cuts and promising additions. With new CAR T-cell therapy coverage and increased rates for crucial lab work, we encourage you to stay informed and take action before the 2025 MPFS comment period ends on September 9, 2024. In our latest blog from Laboratory Economics, find out what these changes mean for your practice and how they will impact patient care. 🔗 https://hubs.li/Q02NF0sX0 #Medicare2025 #HealthcarePolicy #MedicareUpdate #Pathology #MedicareBilling #MPFS

Primary Care Providers ... Did you know the following? HCPCS code G2211 now earns Medicare reimbursement, allowing practices to boost earnings by $16.04 per encounter when paired with office/outpatient evaluation and management (E/M) codes. This supports extra payment for delivering valuable, long-term care. CMS extends coverage to telehealth, including audio-only consultations. G2211 is typically billed during routine primary care visits, emphasizing the ongoing practice-patient relationship. Even in multi-practitioner settings, it's usable in the absence of the patient's regular physician. While subspecialty practices can use G2211 for single serious or complex conditions, it's especially suited for primary care. Its adoption by commercial plans, Medicare Advantage, and Medicaid varies. Exceptions include billing G2211 for episodic care like urgent care clinics and its incompatibility with modifier 25. Federally Qualified Health Clinics and Rural Health Clinics are exempt from billing G2211. #MedicarecodeG2211  #EHRautomation #Elation #primarycarephysician

I find this trend really interesting. Has there ever been substantiated data to suggest that approvals amongst payers is almost entirely relative to the prevailing winds of the organization? (IE: In January 2024, Inpatient admission picked up for M.A. plans, this led to increasing denials in February which led to the uptick hitting the peak of the wave and then it trended back down). Ronald Hirsch, MD, FACP, CHCQM, CHRI, ACPA-C, do you believe that payers utilize a top-down retrospective analysis of their director's recent productivity in concert with adjacent directors in same role to "peer-pressure" the into changing uphold versus denials? If substantiated, couldn't this be utilized as a bad-faith argument against an organization in that it could then be inferred they aren't objectively reviewing cases one-off, but they are "recognizing upswells in the wave" and nipping them in the bud (both organizationally as well as individually)?

Love to see this policy move toward greater investment in longitudinal care. More investment is needed to support the work of #primarycare, but this is a great start, and Elation was all in on advocating for the 1/1/24 implementation. Now we need commercial payers to jump on board. Read more about #G2211 and how to use it in our latest blog post⤵️

Medicare code G2211 is designed to help physicians address complex medical issues. Learn more about the use of this new code and its potential effect on physician compensation. https://rb.gy/qjld0l #CareerWellbeing #ProviderCompensation #MedicareCoding