Centers for Medicare and Medicaid Services Administrator Seema Verma has tasked her Patients Over Paperwork team with exploring what CMS can do to improve Prior Authorization (PA) burdens as part of the eighth topic addressed under the initiative. They are conducting many listening sessions with various stakeholders over the next few weeks, including a wide range of providers and health plans, to gather information on burdens and suggestions on what CMS can do on this issue. They are also visiting practices to observe the PA process in action. In this effort, CMS is looking for data on PA. They are particularly interested in the following data points in advance of taking meaningful action: Practice costs to complete PA tasks, particularly […]
This is in regard to the 2020 Medicare Physician Fee Schedule Proposed Rule, released by the Centers of Medicare and Medicaid Services (CMS) on July 29, 2019. Specifically, the proposed rule proposed a recommended work Relative Value Unit (RVU) of 9.03 of CPT code 27279, Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device. In the proposed rule, CMS indicated they were seeking comment on whether to adopt a work RVU of 20.00 which is the work RVU for CPT code 27280, Arthrodesis, open, sacroiliac joint, including obtaining bone graft, including instrumentation, when performed to achieve site-of-service parity and eliminate incentives for facilities to use a […]
Read the Summer 2019 issue of Vertebral Columns. In this issue: Medicare, Machine Learning & Artificial Intelligence in Spine Surgery, Maximizing Lordosis with MIS TLIF, Using Digital Media to Market Your Practice, Back Pain in Children & Adolescents, and Complex Regional Pain Syndrome!
On July 29, CMS published the proposed Physician Fee Schedule Rule for the 2020 Outpatient Prospective Payment System. The proposed changes encourage site-neutral payment between certain Medicare sites of services as well as proposing updates and policy changes under the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. According to CMS, the proposed polices in the CY 2020 OPPS/ASC Payment System proposed rule would further advance the agency’s commitment to increasing price transparency—including proposals for requirements that would apply to each hospital operating in the United States)—rethinking rural health, unleashing innovation, reducing provider burden, and strengthening program integrity so that hospitals and ambulatory surgical centers can operate with better flexibility, and patients have what […]