Bottom line Recent class action settlement gives all out-of-network (“ONET”) physicians important – and often overlooked – rights under the Employee Retirement Income Security Act of 1974 (“ERISA”) in connection with repayment demands. What is this case about? After paying claims submitted…
Effective January 1, 2021, the Centers for Medicare & Medicaid (CMS) finalized significant changes to the office and outpatient evaluation and management (E/M) services (CPT codes 99202-99215) for both new and established patients.
Specially, CMS increased the valuations for the majority of these services; developed new documentation requirements that allow providers to bill by time or medical decision making; and created a new add-on code for prolonged time on the day of service, HCPCS Code G2212 (for Medicare patients)/CPT code 99417.
Additionally, please find the spreadsheet that details the provisions of the COVID relief pieces of the end-of-year bill and includes a tab on the PPP sections.