What is Medical Reimbursement? - AAPC Except for specific national mandates such as reimbursement for childbirth, commercial payers determine their own rules of medical necessity or payment and reimbursement fee schedules Federal intermediaries are regulated as contractors by the Centers for Medicare Medicaid Services (CMS)
2025 CMS Final Rule - AAPC MEDICARE PAYMENT RATES Medicare reimbursement cuts are among the most impactful changes in the 2025 Final Rule: Payment Cuts: Average payment rates under the PFS will drop by 2 93% in 2025 Lower Conversion Factor: The new rate is $32 36, reflecting a 2 83% decrease from 2024
Work RVU Calculator (Relative Value Units) - AAPC This course teaches medical billing and reimbursement issues, such as how to take the codes that have already been assigned by the coder and process a claim form, and how to work with 3rd party payers to make sure the claim is processed correctly
Bill G2211 With Confidence (and Modifier 25) - AAPC HCPCS Level II add-on code G2211 recognizes the ongoing relationship between patient and physician It also provides additional reimbursement for the extra time and effort it takes to manage the unique complexities of a patient’s needs for the long-term through conversations, comprehensive care plans, and collaborative decision making
Reimbursement Policy Podiatry - AAPC This reimbursement policy applies to all health care services billed on CMS 1500 forms and, when specified, to those billed on UB04 forms (CMS 1450) Coding methodology, industry-standard reimbursement logic, regulatory requirements, benefits design and other factors are considered in developing reimbursement policy
Telehealth 2025: The Final Rule - AAPC Knowledge Center Medicare reinstates certain pre-pandemic telehealth policies COVID-19 public health emergency waivers that applied to Medicare Part B policies for The 2025 PFS final rule is the final word for telehealth services effective Jan 1, 2025, unless Congress acts
Differentiate Modifiers GC, GE for Teaching Physician Services . . . - AAPC Hint: Mastering the primary care exception rule helps open reimbursement doors When your provider performs services as a teaching physician (TP), their coding may change quite a bit A significant reason for that is the challenges inherent to supervising residents
What Is Revenue Cycle Management (RCM)? - AAPC Data analytics is the process of reviewing reports (for denials, appointments, charges billed, reimbursement collections, etc ) and other documentation and looking for trends within the revenue cycle This includes noting trends such as errors, missed billing opportunities, and determining whether revenue is up or down
What is Medical Coding? - AAPC Medical billers, on the other hand, process and follow up on claims sent to health insurance companies for reimbursement of services rendered by a healthcare provider The medical coder and medical biller may be the same person or may work with each other to ensure invoices are paid properly
Telehealth: Medicare Policy for CY 2025 - AAPC Rulemaking and lawmaking keep telemedicine a viable solution for the masses, for now Now that the dust has settled on the American Relief Act, 2025, Medicare policy for telehealth services is extended through March 31, but then what?