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News

CMS lifts claims hold on PFS, other claims amid government shutdown

The Centers for Medicare & Medicaid Services Oct. 21 announced that it has instructed all Medicare Administrative Contractors to lift a hold and begin processing claims dated Oct. 1 and later for those paid under the Medicare Physician Fee Schedule, ground ambulance transport claims and federally qualified health center claims.
Special Bulletin
Member

Special Bulletin: CMS Issues Physician Fee Schedule Final Rule for CY 2025

The Centers for Medicare & Medicaid Services (CMS) Nov. 1 issued a final rule that will update physician fee schedule (PFS) payments for calendar year (CY) 2025. The rule also includes policies related to the Medicare Shared Savings Program (MSSP) and the Quality Payment Program (QPP), both of which were created by the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.

Reimbursement reform: Educating physicians

It was standing room only at a January physician education event in South Carolina as 140-plus providers in the Palmetto Health Quality Collaborative gathered from around the state’s Midlands regio

The key to new payment programs? Data management.

Value-based payment approaches, including Medicare’s Quality Payment Program for physicians and other eligible clinicians, tie fees and bonuses to how well providers perform on various qualit