The Provider’s Role in Risk Adjustment Coding
Physicians must code diagnoses properly to succeed under Medicare & other value-based contracts Each year, CMS sets cost benchmarks for every Medicare member, based on the patients’ diagnoses during the prior year. But what if the physician hasn’t reported their patients’ health information accurately or fully? The result is often benchmarks that are set too […]
Medicare Payment Advisory Commission (MEDPAC) Reimbursement of Evaluation & Management Codes

MEDPAC recently issued a report to Congress. It reviewed the reimbursement levels for office-based E/M codes versus procedural codes. The commission recommended a significant increase in the reimbursement of E/M codes. The increase ranged from 5% to 30% as a pay increase. The commission stated that over time there has been a “passive devaluation” of […]