IN THIS ISSUE
* Welcome
* Electronic Prescribing (eRx): 2011 Incentive Program Update
* Billing Tip: Medicare To Pay For Preventative Exams In 2011
* Congress Votes To Further Delay Physician Pay Cut
* New Features
* Upcoming Events
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Welcome
Greetings to all of our Azalea Health Innovations friends and thank you for reading our newsletter. We hope all of our readers enjoyed their holiday season, and we wish everyone a Happy and Successful New Year!
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Electronic Prescribing (eRx): 2011 Incentive Program Update
In November the Centers for Medicare & Medicaid Services (CMS) announced that beginning in 2012, eligible professionals who do not successfully utilize electronic prescription software may be subject to a payment adjustment on their Medicare Part B Physician Fee Schedule (PFS) covered professional services. Section 132 of the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA) authorizes CMS to apply this payment adjustment whether or not the eligible professional is planning to participate in the eRx Incentive Program.
From 2012 through 2014, the payment adjustment will increase each calendar year. In 2012, the payment adjustment for not successfully utilizing electronic prescription software will result in an eligible professional or group practice receiving 99% of their Medicare Part B PFS amount that would otherwise apply to such services. In 2013, an eligible professional or group practice will receive 98.5% of their Medicare Part B PFS covered professional services for failure to utilize e-prescribing software. In 2014, the negative payment adjustment increases to 2%, resulting in an eligible professional or group practice receiving 98% of their Medicare Part B PFS covered professional services.
The payment adjustment does not apply if less than 10% of an eligible professional’s (or group practice’s) allowed charges for the January 1, 2011 through June 30, 2011 reporting period are comprised of codes in the denominator of the 2011 eRx measure.
Denominator codes are as follows:
90801, 90802, 90804, 90805, 90806, 90807, 90808, 90809, 90862, 92002, 92004, 92012, 92014, 96150, 96151, 96152, 99201, 99202, 99203, 99204, 99205, 99211, 99212, 99213, 99214, 99215, 99304, 99305, 99306, 99307, 99308, 99309, 99310, 99315, 99316, 99324, 99325, 99326, 99327, 99328, 99334, 99335, 99336, 99337, 99341, 99342, 99343, 99345, 99347, 99348, 99349, 99350, G0101, G0108, G0109
Please note that earning an eRx incentive for 2011 will NOT necessarily exempt an eligible professional or group practice from the payment adjustment in 2011.
How to Avoid the 2012 eRx Payment Adjustment:
Eligible professionals – An eligible professional can avoid the 2012 eRx Payment if (s)he:
- Is not a physician (MD, DO, or DPM), nurse practitioner, or physician assistant as of June 30, 2011 based on primary taxonomy code in NPPES;
-Does not have prescribing privileges. Note: (S)he must report HCPCS code (G8644) at least one time on an eligible claim prior to June 30, 2011;
-Does not have at least 100 cases containing an encounter code in the measure denominator;
-Becomes a successful e-prescriber; and
-Reports the eRx measure for at least 10 unique eRx events for patients in the denominator of the measure.
Group Practices – For group practices that are participating in eRx GPRO I or GPRO II during 2011, the group practice MUST become a successful e-prescriber. Depending on the group’s size, the group practice must report the eRx measure for 75-2,500 unique eRx events for patients in the denominator of the measure.
For additional information, please visit the “Getting Started” webpage at http://www.cms.gov/erxincentive on the CMS website for more information; or download the Medicare’s Practical Guide to the Electronic Prescribing (eRx) Incentive Program under Educational Resources.
We will be launching our ePrescribing software early this year! Please note, ePrescribing will be integrated in both Azalea PM™ and Azalea LabHub™ as well. To find out more about purchasing our ePrescribing software or how you can add ePrescribing your current Azalea PM™ or Azalea LabHub™ system, contact sales@AzaleaHealth.com.
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Billing Tip: Medicare To Pay For Preventative Exams In 2011
Beginning January 2011, Medicare will begin reimbursing for two new HCPCS codes (G0438 and G0439) for annual wellness visits, which are services they previously would not pay for. This new provision comes via the Patient Protection and Affordable Care Act (ACA) and should yield some significant revenue to primary care providers.
G0438 is an initial visit for annual wellness which includes a personalized prevention plan of service. G0439 is a subsequent annual wellness visit and is to be used for each year after the first G0438 is billed. G0439 also includes a personalized prevention plan of service. Reimbursement for these codes will be based on current relative value units (RVUs) for CPT codes 99204 (for G0438) and 99214 (for G0439).
For additional information, please click here to view the MLN Matters article recently released from CMS.
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Congress Votes To Further Delay Physician Pay Cut
Legislation was recently passed by Congress to counteract the Sustainable Growth Rate (SGR) formula that would have reduced physician reimbursement rates from Medicare. Both the US House of Representatives and Senate passed this legislation on December 8th-9th. President Obama signed the Medicare and Medicaid Extenders Act of 2010 which will ultimately postpone the 25% pay cut to physicians until 2012.
A summary of the Medicare and Medicaid Extenders Act of 2010 can be accessed by clicking here.
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New Features
Just last month, new features such as the ability to quickly schedule a patient for multiple appointments, pre-verify patients’ Insurance eligibility information from within the Scheduler, add unapplied payments and easily post them to encounters that have patient balances, quickly view encounter information without having to open the encounter, and the ability to edit a predefined custom provider schedule were all added to Azalea PM™. If you missed December’s New Features email, we invite you to visit the following link and see the many ways these features can benefit your practice:
New Features - December 2010. Look out tomorrow for our New Features – January 2011 email and learn about the newest features developed to enhance your practice management software!
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Upcoming Events
AHI will be showcasing a variety of products and services, including Azalea PM™ and Praxis EMR, at the MGMA/ Winter Conference in Birmingham, AL. The conference will be held at the Wynfrey Hotel, March 2-4, 2011.
AHI will be exhibiting Azalea PM™ and many other products and services at the upcoming MGMA/ Annual Conference in Orlando, FL. The conference will be held at the Caribe Royale Resort, May 9-10, 2011.
AHI will be showcasing Azalea LabHub™ at the CLMA ThinkLab 2011 Conference in Baltimore, MD. The conference will be held at the Baltimore Convention Center, May 22-24, 2011.
AHI will be promoting Azalea PM™, EMR solutions, and our Revenue Cycle Management services at the 108th Family Medicine Weekend for the Florida Academy of Family Practitioners (FAFP). The conference will be held July 15-17, 2011 at the Hilton in Orlando, FL.
AHI will be exhibiting our Azalea PM™ product, Revenue Cycle Management Services, and much more at the MGMA / Summer Conference in Destin, FL. The conference will be held at the Hilton Sandestin Beach and Golf Resort. August 1-3, 2011.
We hope to see all of you at our upcoming events!
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Thank you!
Azalea Health Innovations, Inc.
100 North Patterson Street
Valdosta, GA 31601
Toll Free: 877-777-7686
Local: 229-269-4620
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Web: http://www.AzaleaHealth.com
Email: info@azaleahealth.com
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