Author: Mario Fucinari DC, CCSP, APMP, MCS-P, CPCO

Medicare Requiring Modifier GP on Physical Therapy Services

Medicare Requiring Modifier GP on Physical Therapy Services

On January 1, 2018, the Centers for Medicare and Medicaid Services (CMS) released MLN Matters Number: MM10176. In this notice, CMS identified certain services subject to the therapy cap. The revision became effective on January 1, 2018. Due to this revision, some providers have begun to receive claim rejections because they are not using the appropriate modifier.

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Locum Tenens and Practice Coverage

Locum Tenens and Practice Coverage

The demands of practice can often be daunting. We know we should take care of ourselves and take a break once in a while. Getting away is not always practical. Overhead is still present, the staff doesn’t always keep to our schedule because of family obligations, and of course, the patients seemingly want us on call 24/7. We can hire another doctor to practice in the office with us, but it is hard to find someone that the patients love who practices in the same style as we do. Then, of course, we have government and insurance regulations. Certification for another doctor for Medicare, PPO restrictions and credentialing can be tedious, especially when we just want them to fill in on a temporary basis.

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CMS Eases Eligibility Threshold Again on MIPS Participation

CMS Eases Eligibility Threshold Again on MIPS Participation

The Centers for Medicare and Medicaid Services (CMS) announced today that they intend to further raise the threshold for participation in its Merit-Based Incentive Payment System (MIPS). In its much-anticipated proposed 2018 rule for the Quality Payment Program (QPP), CMSproposed to increase the threshold to exclude MIPS-eligible clinicians or groups with $90,000 or less in Part B-allowed Medicare charges or 200 or fewer Part B Medicare beneficiaries.

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Strategic Health Solutions Audits Chiropractic Medicare Records

Strategic Health Solutions Audits Chiropractic Medicare Records

Strategic Health Solutions, a contractor working for Medicare, is auditing chiropractic records throughout the United States. Many doctors in multiple states, most recently Illinois, have received requests to send in records in response to a Medicare audit conducted by Strategic HealthSolutions. This round of audits is a Centers for Medicare and Medicaid Services (CMS) initiative to request, receive and review medical records through its Medicare Contractors, including Strategic Health Solutions.

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