Business of Medicine
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Denied, delayed, distressed
Prior authorization was designed to control costs and ensure appropriate care—but for many patients and clinicians, it causes treatment delays, denials, and administrative burdens.
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Key points of the 2025 Medicare Physician Fee Schedule
CMS has released the 2025 Medicare Physician Fee Schedule rule. Read a summary of key points that clinicians need to know about.
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The Medicare conversion factor: What is it and why is it punishing physicians?
This year’s final rule from CMS provided the long-expected but unwelcome news of a 2.8% cut in the 2025 Medicare conversion factor.
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Coding & billing: A look into G2211 for visit complexities
To continue to bring awareness to our members, we once again discuss this new add-on Healthcare Common Procedure Coding System code finalized by the Centers for Medicare & Medicaid Services […]
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Coding & Billing: A look into bronchoscopic codes and digital evaluations
Pulmonary physicians and particularly interventional bronchoscopists have been receiving denials when CPT® codes 31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe and […]
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Highlights of the 2024 Medicare Physician Fee Schedule proposed rule
The suggested Medicare Physician Fee Schedule for calendar year (CY) 2024 was announced by the Centers for Medicare & Medicaid Services (CMS) in July 2023. Physicians who specialize in pulmonary, […]
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Nonphysician practitioner (NPP) billing for evaluation and management (E/M) and critical care services: A sea change now in effect!
In the 2022 Medicare Physician Fee Schedule, the Centers for Medicare and Medicaid Services (CMS) further refined E/M billing by addressing split/shared visits between nonphysician practitioners (such as nurse practitioners […]
