December 9, 2021

Spine Surgery Procedure RVUs Reviewed as Part of the Medicare Physician Fee Schedule 2022 Final Rule

Spine Surgery Procedure RVUs Reviewed as Part of the Medicare Physician Fee Schedule 2022 Final Rule As part of the 2022 Medicare Physician Fee Schedule proposed rule, several sets of spinal surgical procedures were included as either new to the Physician Fee Schedule or existing services that were reviewed or revalued. Specifically, CMS reviewed new codes for arthrodesis decompression when performed with fusion, new codes for basivertebral nerve ablation (Intracept procedure), and a revised value for insertion of spinal stabilization devices (Coflex). CMS proposed updating the Relative Value Units (RVUs) assigned to Current Procedural Terminology (CPT) 22867, “Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level” (Coflex). The current work […]
December 9, 2021

CMS to Apply MIPS Automatic Extreme and Uncontrollable Circumstances Policy for the 2021 Performance Year

CMS to Apply MIPS Automatic Extreme and Uncontrollable Circumstances Policy for the 2021 Performance Year On November 11, 2021, CMS announced they are applying the Merit-based Incentive Payment System (MIPS) automatic extreme and uncontrollable circumstances (EUC) policy to ALL individually eligible MIPS clinicians for the 2021 performance year (PY). Please note that this announcement is for PY2021 only. The automatic EUC policy only applies to MIPS eligible clinicians who are eligible to participate in MIPS as individuals. The automatic EUC policy does not apply to groups, virtual groups, or Alternative Payment Model (APM) entities. MIPS-eligible clinicians who are eligible to participate in MIPS as individuals You don’t need to take any action to have the automatic EUC policy applied to you. You’ll be automatically […]
December 9, 2021

CMS Releases 2022 Outpatient Prospective Payment System/ Ambulatory Surgical Center Final Rule

CMS Releases 2022 Outpatient Prospective Payment System/ Ambulatory Surgical Center Final Rule On November 2, 2022, CMS released a final rule for the Calendar Year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System. Price Transparency Beginning January 1, 2022, CMS will increase the penalty for some hospitals that do not comply with the Hospital Price Transparency final rule. Specifically, CMS is setting a minimum civil monetary penalty of $300 per day that will apply to smaller hospitals with a bed count of 30 or fewer, and a penalty of $10 per bed per day for hospitals with a bed count greater than 30, not to exceed a maximum daily dollar amount of $5,500. […]
December 9, 2021

CMS Releases 2022 Medicare Physician Fee Schedule Final Rule

CMS Releases 2022 Medicare Physician Fee Schedule Final Rule On November 2, 2021, CMS published a proposed rule for the 2022 calendar year (CY) Medicare Physician Fee Schedule (PFS). CY 2022 PFS Rate Setting and Medicare Conversion Factor The final conversion factor for 2022 is $33.5983, which reflects the expiration of the 3.75% increase for services furnished in 2021, the 0.00% update adjustment factor specified under section 1848(d)(19) of the Act, and a budget neutrality adjustment of –0.10%. Clinical Labor Pricing Update CMS finalized the phased-in implementation of the clinical labor update over 4 years to transition from the current prices to the final updated prices in 2025. Clinical labor rates were last updated in 2002 using Bureau of Labor […]