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Industry News Blog posts

April 13, 2021
by Simon Hughes

How Does the American Rescue Plan Impact Your Facility?

The newly enacted American Rescue Plan centers on the ongoing battle against the COVID-19 pandemic and rebuilding the economy amidst the public health crisis. This means that the $1.9 trillion COVID-19 relief plan will impact hospitals and other healthcare providers fighting the virus and have implications for health systems, including new coverage policies.  With offices […]

April 1, 2021
by Simon Hughes

How to Stay Compliant and Increase Your Revenue with COVID Vaccine Medical Billing

The Centers for Medicare & Medicaid Services (CMS) recently increased Medicare’s reimbursement rates for hospitals, pharmacies, physicians, and others for administering COVID-19 vaccines. These changes by CMS are in support of the administration’s efforts to ensure that all Americans can be vaccinated against COVID-19 as soon as possible. The pandemic has certainly resulted in rapid […]

November 20, 2020
by Simon Hughes

COVID-19 Vaccine Codes

Updated December 22, 2020: The COVID pandemic has had tremendous emergent impact upon medical care, testing and supplies.  In response, the AMA’s CPT Editorial Panel has had to rapidly create and establish new CPT codes for COVID reporting, tracking and analysis to support data-driven planning and resource allocation. On December 12, 2020, the Pfizer COVID […]

September 21, 2020
by Simon Hughes

Proposed Evaluation and Management Coding Changes for 2021

It has taken 30 years, but the AMA and CMS have performed a complete overhaul of the Evaluation and Management (E/M) documentation and coding guidelines and they are set to be implemented January 1, 2021.  The hope is that the burden associated with meeting the 1995 or 1997 guidelines will finally be lifted and patient […]

August 13, 2020
by Simon Hughes

Changes to Medicare Provider Enrollment Due to COVID-19

The Covid-19 National Health Crisis has impacted Federally Community Health Centers (CHCs) in ways never before seen.  Many are involved in testing and have ramped up their Telehealth process.  However, CHCs across the country are seeing significant declines in patient visits, staff shortages due to exposure and ultimately, a challenging financial landscape. In addition to […]

June 25, 2020
by Simon Hughes

HCPCS CS Modifier Guidelines Related to COVID-19 Testing for Community Health Centers

Updated 8/27/2020 The Family First Coronavirus Response Act (FFCRA), which went into effect March 18, 2020, waives cost-sharing (i.e., coinsurance and deductibles) by patients receiving COVID-19 testing-related services, as well as the testing itself. This Act applies to group and individual health plans including Medicare, Medicare Advantage, Medicaid, CHIP, and private payers. The Coronavirus Aid, […]

June 16, 2020
by Simon Hughes

Coding Guidelines for SARS-CoV-2 (COVID-19)Testing in Health Centers

Updated 12/22/2020 On May 24, 2020 the Department of Health and Human Services presented a COVID-19 Strategic Testing Plan to Congress which describes, among other things;  detailed information on various testing methodologies; medical device and test availability; and, research and advice designed to inform the government as plans for re-opening the country are made and […]

May 27, 2020
by Simon Hughes

PMG Welcomes New Provider Enrollment & Credentialing Client in New York

May 1, 2020
by Simon Hughes

Community Health Center Telehealth Services covered by Medicare during the COVID-19 Public Health Emergency – Highlights from the latest Medicare Learning Network

Updated 10/6/2020 On April 17th, CMS released the much anticipated Medicare Learning Network Matter article (SE20016) as guidance for health centers regarding telehealth reimbursement during the COVID-19 and 1135 Waiver Public Health Emergency (hereafter “COVID PHE”). Health centers had been waiting for this directive since March 17th when expanded language around Medicare billing was provided […]

March 26, 2020
by Simon Hughes

PMG Announces New Provider Enrollment & Credentialing Client, Shalom Health Care Center in Indianapolis, Indiana.

PMG Inc., the nation’s leading full-service revenue cycle management company dedicated exclusively to FQHCs and CHCs, announces its newest Provider Enrollment & Credentialing client, Shalom Health Care Center in Indianapolis, Indiana. PMG’s comprehensive suite of services PMG is providing Shalom Health Center with services including confirmation of the enrollment status of all providers with all […]