MEDICAL BILLING BLOG

On February 26, 2021, the Centers for Medicare & Medicaid Services (CMS), together with the Department of Labor and Department of the Treasury, issued new GUIDANCE that removes barriers to COVID-19 diagnostic testing and vaccinations, and strengthens requirements that plans and issuers cover diagnostic testing without cost sharing.

This CMS guidance raises some key points and a few questions that need to be inspected by Healthcare Compliance Attorneys of providers/organizations involved with testing and vaccinations. With this blog post we are providing further details about the CMS guidance and we are highlighting questions that the affected providers/organizations need to have answered by your Healthcare Compliance/Billing Attorney.

Key Points and questions:

1. It is critical that individualized medical necessity screens remain in place.

• • This guidance document makes it clear that any testing done without “individualized clinical assessment” would be considered either public health surveillance or a job requirement and would not be required to be paid by insurance companies.

2. It is critical to get the interpretation of these new guidelines from a healthcare compliance and billing legal expert because there are some unclear areas in the guidelines. Specifically:  

• • On the one hand, the document says that payers cannot deny coverage of a COVID-19 test for lack of medical necessity. On the other hand, they say that payers must assume when they receive a claim that it reflects an "individualized clinical assessment." This seems to imply there has in fact been a medical necessity determination by a medical provider. 
     
    • If an "individualized clinical assessment" does imply the presence of a medical necessity, then how does the example of "I want to be sure I am COVID-19 free before seeing my parents" require such assessments to be modified so that a COVID-19 test is approved for reasons of this nature? 
  • The document seems to emphasize the importance of an individual seeking the test vs the test being required for Public Health Surveillance or employment. How does the distinction between a test being required interact with medical necessity of a test that is determined via an “individualized clinical assessment?” 

• • • If I am seeking a test because I need to show clear results to attend an optional event like a ballgame, a concert, a visit to a nursing home, a cruise, etc., then if prior to testing I have an “individualized clinical assessment” (e.g., a screening questionnaire), does that meet the criteria for a billable test since I am seeking the test so that I can attend an optional event AND I am receiving an individualized screening for medical necessity? These examples seem extraordinarily similar to the specific example given by CMS of an asymptomatic person with no know exposure having the COVID-19 test covered because the person wants  to visit a parent or relative.
    • If I need to have a clear test for my job AND I have an individualized medical necessity screen applied, is there any reason that the test cannot be billed to insurance if I show medical necessity through this “individualized clinical assessment?” Prior to this CMS clarification, payers had to cover a COVID-19 test when a medical necessity screen based upon symptoms or potential exposure warranted it. Does the fact that in some situations, such as “I want to visit my parents,” traditional medical necessity based upon symptoms or exposure risk seems to no longer be a requirement mean that a medical necessity screen can no longer be used to justify insurance billing of employee tests justified by exposure or symptoms and ordered via an “individualized clinical assessment?” In other words, has the medical necessity screen lost importance in determining if you can or cannot bill insurance for employees?  
  • Does any of this impact the wording of agreements that might be put in place with organizations requesting testing to help to ensure the language in the agreement does not run afoul of any of the public surveillance and employment testing exclusions?

 More Detail behind the points and questions above:

There are a few key areas on the CMS guidance document that prompted the questions I outlined above. As you can see on the document, there are 13 questions that are asked and answered. I spotlight Question 2 and the answer supplied by CMS:

Q2 – May plans and issuers distinguish between COVID-19 diagnostic testing of asymptomatic people that must be covered, and testing for general workplace health and safety, for public health surveillance, or for other purposes not primarily intended for individualized diagnosis or treatment of COVID-19?

Answer – Yes. Plans and issuers must provide coverage without imposing any cost-sharing requirements (including deductibles, copayments, and coinsurance), prior authorization, or other medical management requirements for COVID-19 diagnostic testing of asymptomatic individuals when the purpose of the testing is for individualized diagnosis or treatment of COVID-19. However, plans and issuers are not required to provide coverage of testing, such as for public health surveillance or employment purposes. But there is also no prohibition or limitation on plans and issuers providing coverage for such tests. Plans and issuers are encouraged to ensure communications about the circumstances in which testing is covered are clear. To the extent not inconsistent with the FFCRA’s prohibition on medical management, plans and issuers may continue to employ programs designed to detect and address fraud and abuse.

This is the section that prompts the questions about whether “individualized screening” moves a test form the public surveillance realm to the covered test realm. The concern is whether loosening the “medial necessity” guidelines apparently to allow individuals to have covered COVID-19 tests for any reason they deem necessary impacts the weight “individualized screening” has held in relation to COVID-19 testing up to this point in terms of justifying billing based upon medical necessity.

The answer below to Q1 in the guidance document is what creates the uncertainty between the purpose of “individualized clinical assessment” when reasons such as “visiting my parents” now are covered for testing.

“When an individual seeks and receives a COVID-19 diagnostic test from a licensed or authorized health care provider, or when a licensed or authorized health care provider refers an individual for a COVID-19 diagnostic test, plans and issuers generally must assume that the receipt of test reflects an  “individualized clinical assessment” and the test should be covered without cost sharing, prior authorization or any other medical management requirements.”

This statement is also what makes it critical that you have a screening that results in a "yes" where a doctor orders the test or a "no" where a doctor does not order the test. As long as the doctor does not order test for people that do not pass the screen then it should fall under the “individualized clinical assessment” point made above.

Finally, the document also emphasizes the importance of an “individualized clinical assessment” when it says test must be covered "...when a licensed or authorized healthcare provider administers or has referred a patient for such a test." 

Conclusion:

Obviously, this blog post poses more questions than it does clear guidance. However, as has been the case from the beginning of COVID-19, these situations are unprecedented. As such, the devil is in the “legal details.”

I would argue that all of this guidance means:

1. Medical necessity is still required,
2. The scope of medical necessity has expanded, and
3. As long as an individual screening for medical necessity is used, individuals meeting the new medical necessity guidelines are billable to insurance.

 What is far from clear is exactly how this guidance specifically expands the definition of “medical necessity.”

Thus, as emphasized in the beginning of this blog post, it is critical to obtain your Healthcare Attorney’s opinion on all the points and questions outlined in this post and in the CMS GUIDANCE document.

About ClaimCare ®                        

ClaimCare has 30 years of medical billing experience. We have an established 100% USA-Based medical billing team that has been assembled through a thorough pre-employment screening. All personnel participate in on-going training and strong process management to ensure they deliver only the highest quality medical billing services to clients. 

ClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.” The honor this time comes from MD Tech Review. The magazine’s Augmenting Medical Billing and Coding Operations article presents solid reasons why ClaimCare has been chosen for this recognition.

For more information, contact sales@claimcare.net, or phone toll-free at (855) 376-7631, or visit the ClaimCare Medical Billing Company website. We can assist your practice and/or facility in numerous ways, including complete certification processing.

      100% USA-Based HIPAA-Compliant Medical Billing Company

Just in case you are not already aware, this memo is to inform you the American Medical Association (AMA) added Current Procedural Terminology (CPT) code 99072, effective September 8, 2020, and has updated information about this code and other codes, which was posted September 22, 2020, on the AMA website in an article titled COVID-19 Coding and Guidance.

Coming rather late in the COVID-19 crisis, this code regards “Additional supplies, materials, and clinical staff time over and above those usually included in an office visit or other non-facility service when performed during a Public Health Emergency as defined by law due to respiratory-transmitted infectious disease.” 

CPT Code 99072 Explained

The earlier announcement explained Code 99072 is used to report additional practice expenses necessary in an office visit or other non-facility setting to mitigate the transmission of the respiratory disease for which the Public Health Emergency (PHE) was declared. These expenses include, but are not limited to, additional supplies such as face masks and cleaning supplies, as well as clinical staff time for activities such as pre-visit instructions and office arrival symptom checks that support the safe provision of evaluation, treatment or procedural services during the respiratory infection-focused PHE.

Instructions state that when reporting 99072, report only once per in-person patient encounter per day, per provider identification number, regardless of the number of services rendered at that encounter. Code 99072 may be reported during a PHE when the additional clinical staff duties as described are performed by the physician or other qualified health care professional in lieu of clinical staff.

Dollar Value To Be Established

This new code does not yet have any dollar value associated with it, but efforts are underway to establish payment. 

CPT Code 86413 Also Approved

As explained in the update, the AMA also approved CPT code 86413, which regards “Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (Coronavirus disease [COVID-19]) antibody, quantitative," in response to the development of laboratory tests that provide quantitative measurements of SARS-CoV-2 antibodies.

Per the standard early release delivery process for CPT codes, note that the code descriptor will need to be manually uploaded into electronic health record systems. In addition to the long descriptor, codes 99072 and 86413 have short and medium descriptors that can be accessed on the above mentioned AMA Website.

For more detailed information on reporting codes 99072 and 86413, please refer to the September Update article on CPT Assistant, the official source for CPT coding guidance.

_________________________

About ClaimCare ® 

ClaimCare has 30 years of medical billing experience. We have an established 100% USA-based medical billing team that has been assembled through a thorough pre-employment screening. All personnel participate in on-going training and strong process management to ensure they deliver only the highest quality medical billing services to clients.

ClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.” The honor this time comes from MD Tech Review. The magazine’s Augmenting Medical Billing and Coding Operations article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition.

For more information, contact sales@claimcare.net, or phone toll-free at (855) 376-7631, or visit the ClaimCare Medical Billing Company website. We can assist your practice and/or facility in numerous ways, including complete certification processing. 

A trend began several years ago for practices to move billing and coding offshore to save money, which has often led to crippling the practices rather than adding any advantage in terms of being more effective, efficient and productive. And money has often been lost rather than saved.

A January 2019 “For The Record” article titled Is Offshore Coding Dead in the Water? tells of a two-year study involving six hospital systems. In an apples-to-apples comparison of USA coders and offshore coders, the offshore coders were less accurate and productive than the USA coders. There was a higher denial rate and lower reimbursement resulting from a lower case mix index. Additionally, offshore coders required longer onboarding.

In the end, the savings realized from employing lower-wage offshore coders was lost to productivity issues and lower reimbursements. All variables considered, offshore coders cost hospitals $3.10 per hour more than their American counterparts.

The study, which was presented in detail at the 2018 American Health Information Management Association (AHIMA) Convention was the first of its kind, and it appears the findings are the first solid numbers supporting a move away from offshore coding solutions. However, warnings from various sources existed long before the study was begun. Law firms, healthcare organizations, publications and IT groups were among those sounding alarms. 

Offshore Medical Billing Poses Security, Legal Issues

As far back as 2012, the Liles/Parker Law Firm, which specializes in Healthcare Law, warned of security and legal issues arising from the use of offshore groups in an article titled Overseas Outsourced Billing and Coding – Compliance Risks. The article opens with, “Thinking of sending your medical billing and coding functions out of the country? You better think twice. While overseas outsourced billing is growing in popularity for medical office functions, this practice represents a unique set of problems for both physician practices and 3rd party billers. And the news is just getting worse." Some points made in the article include:

• You have no guarantees that a coding and billing business overseas is HIPAA compliant or even understands the law at all.
• Providers are responsible not only for their practice, but also for the acts of their business associates and their respective subcontractors overseas.
• Obtaining a judgment against an offshore entity is next to impossible, takes a substantial amount of time, and costs a lot of money.
• Liles/Parker writes, "We had previously reported that the backlog for having a case heard in India was nearly 20 years. But recent estimates by the National Bar Association of India put that figure closer to 350 to 400 years."
• Offshore workers have extorted providers over PHI records. In one case, an employee of a Pakistan billing company contacted the hospital on whose records she was working. She demanded a significant sum of money from the hospital or she would release the medical records on the Internet and anonymously contact United States authorities. Given the legal case backlog information above, the hospital had no option but to pay.

Supreme Court Stepped In After Liles/Parker 2012 Article

The 2013 HIPAA Omnibus Rule prevents medical providers from enforcing HIPAA laws in foreign countries. Providers are responsible for improper disclosures and breaches with business associates and their respective subcontractors overseas. Thus, if a provider offshores billing or EMR the provider is responsible for all HIPAA fines, which could be as much as $10,000 per violation. 

There are some so-called "USA-based" medical billing companies that have home offices in America, but offshore the majority of their work. These companies are dependent upon their foreign workers, but as American companies they have to answer to their clients when problems arise offshore. 

Publications Report Offshore Horror Stories 

A 2013 "Fierce Healthcare" article titled 32,000 Patient Records Exposed On Contractor's Unsecured Website tells of a Tennessee-based hospitalist and intensivist group that contracted with an India company to transcribe care notes dictated by physicians. The contractor was supposed to store protected patient health information on a secure website, but its firewall was down between May 5 and June 24 before the Tennessee group discovered the problem.

Health information on 32,000 patients across 48 states was exposed. Compromised patient information included patients' names, dates of birth, diagnosis description, treatment data, medical history and medical records numbers. According to U.S. Department of Health and Human Services records, it was the second HIPAA breach for the Tennessee group.

The article reports that according to the Ponemon Institute, considered an eminent research center dedicated to privacy, data protection and information security policy, 94% of 80 participating healthcare organizations polled had experienced at least one data breach that they were aware of in the previous two years. Those breaches cost organizations a total of $6.78 billion annually.

IT Companies Warn Against Overseas Medical Billers

Scouring the Internet for multiple IT company remarks on offshore medical billing and coding, here are some summarized views:

• There are always dangers of HIPAA security breaches and violations of patient privacy, but these dangers are intensified with offshore contractors, and immediate fixes are less tenable.  
• Many offshore companies utilize a “bait-and-switch” technique. Initial workers assigned to you are what the company considers as their “best.” Later, these “best” are replaced by the company’s lowest-paid, inexperienced workers who use the login of the original worker. Errors increase, productively drops, and security suffers.
• Low-paid offshore workers are enticed to commandeer ePHI (as referenced in the Liles/Parker information above). Such tactics provide a much greater risk than any possible savings afforded by cheap offshore work.
• Offshore contractors may present a basic package of service, but then charge extra for services that are already bundled in initial agreements by a truly 100% USA-based company like ClaimCare.
• Turnover rate is much higher offshore because employees are always looking for higher-paying jobs, whereas ClaimCare emphasizes medical billing "careers" rather than jobs. One of the things that entices quality people to seek employment at ClaimCare is the emphasis on personal growth opportunities within a company that grows annually.
• Surveys have shown that offshore workers are less experienced than USA-based workers and have little or no understanding of America's complex and everchanging federal and state laws regarding healthcare. 
• In general, without taking into account Daylight Savings Time, the time in India (which has only one time zone) is 10.5 hours ahead of USA central time. (The half-hour aspect arose when the meridians for the Indian subcontinent were created. New Delhi was in between the two and India chose to be 30 minutes between the two time zones.) This time element, along with the language element, affects client and patient contacts to a large degree. It also limits real-time access to patient accounts and revenue cycle management reports.
• Whereas ClaimCare can work on clients' systems or its own, offshore contractors often work only on their own, which leads to lack of transparency in reports and data such as payment posting, collection efforts, charges, third-party payer claims and more.

Groups Push Congress to Delegitimize Offshoring  

Some USA-based groups are pushing Congress to strengthen the HIPAA laws by making offshore medical billing illegal. One such letter to Senators and Representatives contains:  

"A foreign workforce is not accountable to the HIPAA laws, and since the HIPAA laws cannot be enforced overseas, we ask that you protect us by keeping medical billing within the United States. In addition to the security that comes with a USA-based labor force being held accountable to HIPAA laws, this move would also keep medical billing jobs in America. We need your presence in Washington to create and pass legislation that safeguards our sensitive data and preserves the medical industry. Do not work so hard to create safeguards within HIPAA only to see them undermined by offshoring."

ClaimCare Rescues Providers, Facilities from Offshoring  

With deep knowledge of offshore billing issues, ClaimCare steps in with distinctive elements and nuances as a professional medical biller to solve the majority of problems that result from the offshore billing and coding model. In doing so, ClaimCare brings unique solutions that are designed to support effective communication, offer up-to-date healthcare intelligence and security, deliver the right information at the right time and fulfill our mission “To collect the maximum amount for your practice as fast as possible while helping to alleviate costs and hassle for your organization.”

About ClaimCare ®                        

ClaimCare has 30 years of medical billing experience. We have an established 100% USA-based medical billing team that has been assembled through a thorough pre-employment screening. All personnel participate in on-going training and strong process management to ensure they deliver only the highest quality medical billing services to clients.

ClaimCare has once again been named a Top 10 Medical Billing and Coding Company. The honor this time comes from "MD Tech Review." The magazine’s Augmenting Medical Billing and Coding Operations article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition.

For more information, contact sales@claimcare.net, or phone toll-free at (855) 376-7631, or visit the ClaimCare Medical Billing Company website. We can assist your practice and/or facility in numerous ways, including complete certification processing.

100% USA-Based HIPAA-Compliant Medical Billing Company

We are posting this blog for ClaimCare clients and for other medical practices and facilities who have not yet become clients. During this continuing COVID-19 pandemic, we want to proactively explain to all in the healthcare industry why your Account Receivables may be behaving differently than anyone would expect.

In a previous blog I shared how ClaimCare spent significant time, energy and money putting in place a fully-tested, HIPAA-compliant work-from-home option several years ago following a flu season that hit ClaimCare and the nation hard. 

Thus, we are one of the relatively few companies with no interruption or slowdown whatsoever in serving our clients in a timely and responsible manner. This cannot be said about many insurance payers.

Even though ClaimCare has been working our clients’ ARs consistently and hard throughout the COVID-19 pandemic, we are not getting the results these efforts would normally yield. This is because many payers entered the crisis unprepared and are now woefully understaffed.

Anything that requires “human intervention” in order to resolve appeals and other forms of claims reprocessing is taking much longer than normal. Some of our clients’ ARs have not decreased over the past three months as much as we normally are accustomed to seeing due to bottlenecks caused by payers. For example:

• With one very large payer that we can normally call and have a claim put back into reprocess on the same day, we now have difficulty in even conversing with a human.
• Medicare appeals normally take about 30 days to resolve, but now we have claims in appeals from March that still have not processed due to Medicare staff shortages.
• We left multiple messages for the Supervisor of one Medicare Advantage group, and when she finally returned our call she said, “We are doing the best we can, but we can’t give you an update yet on your appeals.”

ClaimCare continues to be very aggressive with these payers within the constraints of an unprecedented event limiting their staffing. We have found chains of command to be very thin and the Insurance Commissioner unable to get involved with pandemic-related slowdowns. We will eventually obtain what is due to our clients because we feel our 100% USA-based team is the best, most professional and most prepared to get the job done.

If anyone reading this blog post – client or non-client – has any specific questions or concerns regarding this current situation, please don’t hesitate to contact us. We in the healthcare industry are all in this together, working to achieve the best for patients, practices, facilities and America.

About ClaimCare ®                        

ClaimCare has 30 years of medical billing experience. We have an established 100% USA-based medical billing team that has been assembled through a thorough pre-employment screening. All personnel participate in on-going training and strong process management to ensure they deliver only the highest quality medical billing services to clients.

ClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.” The honor this time comes from MD Tech Review. The magazine’s Augmenting Medical Billing and Coding Operations article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition.

For more information, contact sales@claimcare.net, or phone toll-free at (855) 376-7631, or visit the ClaimCare Medical Billing Company website. We can assist your practice and/or facility in numerous ways, including complete certification processing.

April 3, 2020 Update to Medicare Telemedicine Notification

At 2:45 this afternoon, CMS notified all providers via Special Edition Message that CMS has made yet another change in the coding requirements for Telemedicine/Telehealth services. Pointed out below are the most critical changes, which pertain to place of service and modifier utilization. Here is the original April 1 Telemedicine Blog Post  that contains the earlier CMS information to which we are now referring. Comparing the April 1 blog to this updated blog will make things less confusing to you. 

04-03-20 Revised Special Edition Telemedicine Message from CMS

Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than 80 additional services to be furnished via telehealth. We will notify you when those services are clearly identified.

For professional claims for all telehealth services with dates of services on or after March 1, 2020, and for the duration of the Public Health Emergency (PHE), telehealth claims need to be billed with:

• Place of Service (POS) equal to what it would have been had the service been furnished in-person. This means you no longer use the 02 Place of Service.
• Modifier 95, indicating that the service rendered was actually performed via telehealth.
• As a reminder, CMS is not requiring the CR modifier on telehealth services.

For telemedicine claims already billed with the “02 Place of Service,” medical billers actively monitoring these claims should show them as having been received and in process.  So, it appears this updated change will only impact claims from today forward. Your medical biller should notify you if they find any problems with older or new telemedicine claims. 

ClaimCare remains on top of all things that impact practices and will continue to monitor these updates.  You may have numerous resources sending information to you. Make sure your medical biller vets every piece of information that is sent to you to ensure its validity.  

We certainly hope you and your staff are staying safe and healthy during this crisis. We encourage you to share with everyone, staff and patients alike, that they can keep updated on the news and recommendations on the government’s Coronavirus.com website.

About ClaimCare

ClaimCare is a 100% USA-based HIPAA-Compliant Medical Billing Company

ClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.” The honor this time comes from MD Tech Review. The magazine’s Augmenting Medical Billing and Coding Operations article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition.

For additional information, contact sales@claimcare.net, or phone toll-free (855) 376-7631, or visit the ClaimCare Medical Billing website. We can assist your practice and/or facility in numerous ways.

This article discusses the impact this will have on the physician's relative value unit (RVU) based on their practice (directly and indirectly), and a list of potentially misvalued services to watch out in 2019.

Why is it important for physicians to know the upcoming RVU calculation changes in the proposed Medicare 2019?

Physicians can earn up to 7% of their Medicare Part B payments in 2021 based on their Medicare 2019. Here is what the vice president of public policy of the American Medical Group Association (AMGA), Chet Speed has to say about it:

"When you think about incentives, generally, you need both a carrot and a stick to make change. With Medicare moving to a value-based system, you need a carrot, in the form of higher payments for doing well, and you need a stick, if you don’t do well, you have less reimbursements. "

How will this impact your practice? Here are some of the calculation changes and adjustments that will take effect on your RVU:

Practice Expense Methodology Calculation Changes

Medicare 2019 will be incorporating two new specialties, which will affect hospitalists and advanced transplant cardiology and heart failure physicians.

Calculation Changes to Direct PE Inputs for Specific Services

Standardization of the following specific services is expected in the proposed Medicare 2019:

• Clinical labor tasks
• Balloon sinus surgery kit comment solicitation
• Scope systems' equipment recommendation
• Existing direct PE inputs updated prices

This includes an update on the prices of the following supplies and equipment:

EQ370: Biopsy guidance software and breast MRI computer aided detection

SA036: Transurethral microwave thermotherapy together with the kit

SA037: Transurethral needle ablation together with the kit

SK050: Neurobehavioral status forms

SL140: Wright's Pack (per slide) and the stain

Calculation Changes to the Indirect PE of Certain Office-Based Services

The indirect PE RVUs for those working in a non-facility setting is expected to increase due to the direct PE costs applied to them. This is because the greater value between the clinical labor costs and the work RVUs in relation to the direct costs of these services will be the value selected in determining their RVU.

List of Potentially Misvalued Services for 2019

Aside from changes to the practice expense methodology calculation, the General Accounting Office and MedPac have also listed the following "potentially misvalued services." This is based on a high volume of codes submitted for review by their office to the CMS.

• Colonoscopy w/lesion removal (45385)
• CT head w/o contrast (70450)
• EGD biopsy single/multiple (43239)
• Electrocardiogram complete (93000)
• Revision of heart chamber (92992)
• Total knee arthroplasty (27447)
• Total hip arthroplasty (27130)
• TTE w/doppler complete (93306)

An additional 72 separate code groups for specific codes are currently on review by the CMS. This is after it has taken a closer look at the rationale provided by the American Medical Association/Specialty Relative Value Scale Update Committee.

Comments on these proposed new valuations are welcomed by the committee. You may submit yours on or before September 10, 2018 for it to be considered.

Impact on Specialty Specific Health Sectors

Those working on specialty specific health sectors, such as the following medical professionals, are also most likely to experience the following adjustments in their overall payment:

• 3% increase for nurse practitioners

• 4% increase for gynecology/obstetrics

• 3% decrease for oncology/hematology

• 4% decrease for dermatology

Given these changes, surprise medical bills and price transparency remains to be the issues facing suppliers and providers.

Would you like more updates about the Medicare 2019 E&M code changes?