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What is medical reimbursement? - AAPC What is medical reimbursement? Reimbursement for procedures and services performed by providers is made by commercial payers such as Aetna, United Healthcare, or federal intermediaries acting on behalf of healthcare programs Reimbursement is based on claims and documentation filed by providers using medical diagnosis and procedure codes
2025 CMS Final Rule - AAPC he 2025 Medicare Physician Fee Schedule (PFS) Final Rule introduces significant changes that will impact reimbursement and compliance requirements
RVU Calculator - AAPC Relative Value Units CPT® RVU calculator provides a quick analysis of the work relative value units associated with a certain volume of CPT or HCPCS codes
IMPORTANT NOTE ABOUT THIS REIMBURSEMENT POLICY 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 This information is intended to serve only as a general resource regarding
What Is Revenue Cycle Management (RCM)? - AAPC Revenue cycle management (RCM) is the process healthcare organizations use to manage financial operations related to billing and collecting revenue for medical services RCM begins when a patient schedules an appointment and ends when the account balance is resolved through reconciliation of insurance payments, contractual adjustments, write offs, or patient payments RCM helps strengthen
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
Getting Reimbursed for Applying Casts and Splints - AAPC The strapping codes are rarely used in cases such as a finger sprain, says Dari Bonner, CPC, CPC-H, CCS-P, the president of Xact Coding Reimbursement and a corporate compliance coding reimbursement specialist for a large health system in Florida Bonner says, Physicians usually will bill the evaluation and management (E M), CPT 99201 - 99220
Bill G2211 With Confidence (and Modifier 25) - AAPC Medicaid and commercial payers are not required to pay for services associated with G2211 To ensure proper reimbursement, you will need to regularly review your payer contracts and fee schedules to understand which payers allow reimbursement
Billing Medicare for Telehealth Services in 2024 - AAPC The Centers for Medicare Medicaid Services (CMS) made several substantial changes to its payment policy for telehealth services furnished to Medicare beneficiaries on or after Jan 1, 2024 Healthcare providers should be aware of the changes to ensure proper claims reporting and reimbursement Medicare Telehealth Code List Update The list of telehealth services houses all the services
When Is It Time to Use G2211? - AAPC Knowledge Center Know when to use this add-on code to capture reimbursement for complex Medicare patient visits Beginning Jan 1, 2024, qualified healthcare providers can Know when to use add-on code G2211 to capture reimbursement for complex Medicare patient visits