Vertebral augmentation and Ortho availability
for Medicare advantage plan - EviCore require Orthopedic surgeon available at site for Vertebral Augmentation.
Have any one come a cross that kind of situation ? What you do ? (Source: Student Doctor Network)
Source: Student Doctor Network - December 4, 2021 Category: Universities & Medical Training Authors: Chn96 Tags: Pain Medicine Source Type: forums
SIJ code change for asc
I have been told the following by my asc. Anyone else ever come across this?
“27096 is not reimbursed by Medicare when performed in an ASC. G0260 replaces 27096” (Source: Student Doctor Network)
Source: Student Doctor Network - December 4, 2021 Category: Universities & Medical Training Authors: Taus Tags: Pain Medicine Source Type: forums
New Medicare LCD Guidelines: No Sedation for ESI/facets
Starting 12/12/21, Medicare no longer consider any form of IV sedation medically necessary for ESI/facets. Granted the majority of my ESI's and MBBs are done awake with local, there are a select few that I think some IV sedation (more than PO) would be helpful for all parties. And definitely Cervical RFAs are smoother with IV sedation.
What are everyone's plans now that Medicare (and likely other insurances to follow) will no longer will reimburse for IV sedation for ESI/facets...
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Source: Student Doctor Network - November 18, 2021 Category: Universities & Medical Training Authors: paintrain Tags: Pain Medicine Source Type: forums
Is medicare reimbursement the best?
Just talked with the biller for the company I am working for. I am in the process of getting credentialed with the all the insurance companies, but have not yet. She informed me that medicare reimburses the highest and that I should expect all other insurance providers to fall in between medicare and medicaid rates.
This is so surprising to me given that Medicare reimburses us $204 for a 90792 and $173 for a 99204.
Can anyone confirm this? (Source: Student Doctor Network)
Source: Student Doctor Network - November 17, 2021 Category: Universities & Medical Training Authors: trixter888 Tags: Psychiatry Source Type: forums
CMS cuts physician pay by 7% over 2 years
2021:
The Centers for Medicare and Medicaid Services (CMS) announced a revised Medicare Physician Conversion Factor (CF) of $34.8931. The CF represents a 3.3% reduction from the 2020 CF of $36.0869. The 2021 Anesthesia CF is $21.5600, this is in comparison to the 2020 Anesthesia CF of $22.2016.
CMS Updates 2021 Physician CF to $34.8931, a 3.3% Reduction from the 2020 CF - McDermott+Consulting
The Centers for Medicare and Medicaid Services (CMS) announced a revised Medicare Physician Conversion Factor (CF) of $34.8931. The CF represents a 3.3...
Source: Student Doctor Network - November 16, 2021 Category: Universities & Medical Training Authors: 2021Doctor Tags: Anesthesiology Source Type: forums
PPS Exempt? Cha-ching. MDACC? CHA-CHING!
(FWIW for price transparency, hospitals of 550 or more beds not complying in 2022 can face up to $5500/day fines instead of the $300/day max now)
Cancer Hospital Payment Adjustment
Since the inception of OPPS, Medicare has paid the 11 hospitals that meet the criteria for “cancer hospitals” under OPPS for covered outpatient hospital services to reflect their higher outpatient costs. CMS will continue to provide additional payments to cancer hospitals so that a cancer...
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Source: Student Doctor Network - November 11, 2021 Category: Universities & Medical Training Authors: TheWallnerus Tags: Radiation Oncology Source Type: forums
Breaking Contract with Insurance Companies?
Long story short. I joined a practice that is in the process of credentialing me. I have only been approved for several insurance companies. The practice utilized a credentialing company to get me started.
I now am considering starting my own practice and leaving the current practice. I was told in the beginning from the credentialing agency that they would not be using my individual NPI, but instead the group's NPI number. I however have found out that Cigna and Medicare do not care which...
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Source: Student Doctor Network - November 7, 2021 Category: Universities & Medical Training Authors: trixter888 Tags: Psychiatry Source Type: forums
Chances IPM Medicare cuts go through
What are the chances these proposed deep medicare cuts to IPM, go through?
It reminds me of the massive 2014 cuts in Stimulators and ESI, which did go through. They have the potential to be quite devastating to practices with large percentages of medicare and medicare-replacement plans.
Thoughts? Predictions? Action plan is they do go through? (Source: Student Doctor Network)
Source: Student Doctor Network - November 3, 2021 Category: Universities & Medical Training Authors: emd123 Tags: Pain Medicine Source Type: forums
MILD Billing
Just started doing some MILD procedures for my vertiflex denials (Medicare advantage plan situation apparently they are "in court").
The code is 0275T however when I select that my EMR auto adds the modifier Q0. I can remove it - but do I? How do you guys bill and get paid for MILD procedure (Source: Student Doctor Network)
Source: Student Doctor Network - October 30, 2021 Category: Universities & Medical Training Authors: swamprat Tags: Pain Medicine Source Type: forums
Anyone know telepsych companies that allow working abroad?
I understand you can't bill medicare/medicaid when abroad, but are there any telepsych companies that are billing largely insurance or will accommodate a physician who is based internationally? (Source: Student Doctor Network)
Source: Student Doctor Network - October 24, 2021 Category: Universities & Medical Training Authors: jbomba Tags: Psychiatry Source Type: forums
Will any of you drop Medicare or restrict Medicare if pay cut goes through?
As the title says, will any of you drop Medicare or restrict how many you see if the 9.x% pay cut goes through? (Source: Student Doctor Network)
Source: Student Doctor Network - October 21, 2021 Category: Universities & Medical Training Authors: myrandom2003 Tags: Pain Medicine Source Type: forums
new facet guidelines
What are the new facet joint guidelines that keep being referenced?
I saw something a while back regarding limiting the numbers of facet procedure per rolling twelve months, but are there new medicare rules regarding therapeutic IA facet injections vs diagnostic?
Is this just medicare for now or have some of the national carriers also changed their facet guidelines this year? (Source: Student Doctor Network)
Source: Student Doctor Network - October 14, 2021 Category: Universities & Medical Training Authors: bedrock Tags: Pain Medicine Source Type: forums
medicare physicals after intern year and license
Has anybody done locum jobs after just an intern year and then getting your license. I see some jobs listed on locumtenans website that states no BE/BC required and job listed for H&Ps only without any labs/medication ordering needed. (Source: Student Doctor Network)
Source: Student Doctor Network - October 14, 2021 Category: Universities & Medical Training Authors: intern_for_life Tags: Internship Source Type: forums
Beggars Can't Be Choosing Wisely
This is an open-book, single question test.
Here is the book:
Centers for Medicare & Medicaid Services Data
Here are the study guides:
Single-Fraction RT for Bone Mets Should Be 'Standard'
In the first-ever 'real world' study of palliative radiotherapy for bone metastases, single and multiple fractions were equivalent.
www.medscape.com (Source: Student Doctor Network)
Source: Student Doctor Network - October 13, 2021 Category: Universities & Medical Training Authors: TheWallnerus Tags: Radiation Oncology Source Type: forums
How would a cash-based clinic change your practice?
Hello everyone. I was thinking today while reviewing insurance denials and limitations of care how much the insurance system is controlling how we practice. Even if not directly by authorizations and denials, they even control us by how our notes are designed, what type of EMR we use, the fact we even use an EMR, and the multitude of other policies we must enforce if we accept Medicare, etc.
My question is this: what would you do different if you were 100% cash-based?
Would you even...
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Source: Student Doctor Network - October 8, 2021 Category: Universities & Medical Training Authors: Ferrismonk Tags: Pain Medicine Source Type: forums
