Imagine your practice as a thriving garden. Just like a garden needs proper care, attention, and nourishment to flourish, your practice's revenue also requires careful cultivation. Let's delve into how billing audits and training can be the essential tools to help your garden of revenue bloom:

Uncovering Hidden Revenue Streams:
Think of your revenue as fertile soil with untapped potential. Billing audits are like a gardener's meticulous inspection of the soil, looking for hidden treasures. They unearth errors, missed opportunities, and discrepancies in your billing and coding processes. With each audit, you uncover new revenue streams that have been there all along, waiting to be harvested.

Maximizing Reimbursements:
Just as a gardener knows how to nurture each plant for optimal growth, your practice needs skilled professionals who understand how to code and document services correctly. Comprehensive training ensures that your team is well-equipped to plant the seeds of accurate billing. When your team knows how to navigate the coding landscape effectively, you can expect better reimbursements for the services you provide.

Reducing Costly Errors:
In the garden of revenue, errors are like invasive weeds. They can choke the life out of your financial landscape. Billing audits help identify and eradicate these errors. Paired with training, they prevent future weeds from taking root. This dual approach reduces costly mistakes and ensures that your revenue garden remains healthy and thriving.

Navigating the Regulatory Maze:
The healthcare industry is like a garden with constantly changing weather patterns. Staying compliant with regulations and guidelines is crucial. Billing audits act as your weather vane, detecting compliance issues before they become storms. With proper training, your team learns to adapt and stay ahead of the regulatory curve, ensuring that your practice is always in alignment with industry standards.


​By embracing the power of billing audits and training, you're not just managing a practice – you're cultivating a flourishing garden of revenue. These tools are your gardening gloves, helping you nurture your financial landscape with care and precision.

The COVID-19 pandemic has made telehealth more popular and accessible than ever before. But not all telehealth changes that were implemented during the public health emergency (PHE) will last forever. Some will expire when the PHE ends on May 11, 2023, while others will continue until December 31, 2024 or beyond.

Behavioral Health Services
During the PHE, Medicare expanded coverage of behavioral health services via telehealth. For example, Medicare allowed Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to provide behavioral health services via telehealth as distant site providers, waived geographic and location restrictions for originating sites for behavioral health services, and permitted audio-only communication platforms for behavioral health services.
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Some of these changes are permanent or extended until December 31, 2024. However, some changes will expire when the PHE ends. For example, Medicare will revert to its pre-PHE list of telehealth services, which means that some behavioral health codes that were added during the PHE will no longer be covered by Medicare via telehealth. Also, Medicare will reinstate the requirement for an in-person visit within six months of an initial behavioral health telehealth service, and annually thereafter, with any provider of the same group and specialty.

Place of Service Codes
During the PHE, Medicare instructed providers to use place of service (POS) code 11 (office) for telehealth services provided to patients in their homes or other locations, instead of POS code 02 (telehealth), which would normally apply for telehealth services. This was done to ensure that providers would receive the same payment rate for telehealth services as they would for in-person services.
Medicare also created a new POS code 10 (temporary lodging) for telehealth services provided to patients who are temporarily located outside their home state or county due to a federally declared emergency or public health emergency.
These changes will remain in effect until December 31, 2024. After that date, Medicare will resume using POS code 02 for telehealth services and discontinue using POS code 10.

Audio-Only Services
During the PHE, Medicare allowed certain telehealth services to be delivered using audio-only communication platforms when the patient does not have the ability for audio and video. This was especially helpful for patients who had limited access to technology or internet connectivity.
This allowance will also expire when the PHE ends, except for behavioral health services, which can continue to be delivered using audio-only platforms until December 31, 2024.
Teaching Physician Supervision
During the PHE, Medicare allowed teaching physicians to virtually supervise residents using real-time audiovisual communication when they provide telehealth services to Medicare beneficiaries until the end of the PHE.
This change will also expire when the PHE ends, except for telehealth services provided by residents in rural areas, which can continue to be virtually supervised by teaching physicians after the end of the PHE.

Billing Rules
During the PHE, Medicare allowed nurse practitioners (NPs) and physician assistants (PAs) to provide and bill for telehealth services under the direct supervision of a physician who is virtually present using real-time audiovisual communication until the end of the PHE.
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This change will also expire when the PHE ends. After May 11, 2023, NPs and PAs will need to bill for telehealth services under their own enrollment or under the general supervision of a physician who is not required to be virtually present.

Conclusion
Telehealth has been a lifeline for many patients and providers during the COVID-19 pandemic. But not all telehealth changes that were implemented during the PHE will last forever. Some will expire when the PHE ends on May 11, 2023, while others will continue until December 31, 2024 or beyond. To stay updated on telehealth policy changes, please visit https://telehealth.hhs.gov/ and https://www.cms.gov/.

The 2021 Evaluation and Management Changes to the Office and Other Outpatient categories was the beginning of many changes to streamline physician documentation and coding, and eliminate “note bloat”.
 
The 2023 CPT will continue to address facility categories of Evaluation and Management including Inpatient Hospital, Observation, Nursing Facility, Home or Residence Services and deletes codes in the Observation, Domiciliary, Rest Home and Assisted Living sites of service.
 
There are new Prolonged Services Codes, and new guidelines for their use.
 
Important changes will be made when a patient is admitted to the hospital in the course of an encounter in another site.  The longstanding “One E/M per patient per day” rule has been updated. 
 
Plan to schedule a webinar or onsite group training this fall.  Call us today to schedule a time for your providers, billers, coders, administrators, and clinical staff.  Everyone in your practice should know about these changes.
 

Unfortunately until further notice CPC courses are being discontinued.  Due to the rising cost of running the class and a low number of students, we are are not able to continue offering the classes.  Contact your local AAPC chapter for a list of classes or exams in your area.  Thanks for your understanding.