What CCM and AWV Undercoding Is Costing California Primary Care Practices Entering Q3?

Image
As California primary care practices enter Q3, many are preparing for increased patient volume, preventive care visits, and chronic disease management. However, while physicians focus on delivering quality care, many practices continue to lose substantial revenue due to CCM (Chronic Care Management) and AWV (Annual Wellness Visit) undercoding. Undercoding occurs when services are billed at a lower level than documentation supports or when eligible CCM and AWV services are not billed at all. Although these errors may appear minor, they can significantly reduce reimbursement over time, creating hidden revenue leaks that impact cash flow, profitability, and practice growth. As payer scrutiny increases in 2026, accurate coding and documentation are more important than ever. Many providers are turning to specialized Primary Care Billing Services , medical billing services , and comprehensive RCM services to improve coding accuracy, reduce denials, and maximize reimbursement. Why CCM and ...

Impact of 2023 MPFS Proposed Rule on Neurology Billing

impactof2023mpfsproposedruleonneurologybilling.jpg

2023 Medicare Physician Fee Schedule Proposed Rule

Recently, the Centers for Medicare & Medicaid Services (CMS) released the CY 2023 revisions to payment policies under the Medicare Physician Fee Schedule (MPFS) and other changes to the Medicare part B payment policies (CMS-1770-P) proposed rule. In this article, we shared the impact of the 2023 MPFS proposed rule on neurology billing, the key points are as follows:

Impact of 2023 MPFS Proposed Rule on Neurology Billing

  • CMS shows the impact of the provisions of the rule to be a zero percent chance for neurosurgery. However, CMS proposes a CY 2023 conversion factor (CF) of 33.0775, which is a 4.42 percent (rounded to 4.5%) reduction relative to the CY 2022 CF of 34.6062, which comes in addition to the pending 4% pay-as-you-go cut that congress postponed last year and the resumption of the 2% annual Medicare payment sequester.
  • CMS received a request to designate CPT code 23091 (Allograft, structural, for spine surgery only) as potentially misvalued. CMS has disagreed with the rationale provided by the requester and is proposing not to designate the procedure as misvalued.
  • CMS is considering proposals to rebase and revise the Medicare Economic Index (MEI) cost share weights, and the agency is soliciting comments on this issue. The MEI measures the input prices for providing physician services. The agency proposes a new methodology allowing data to reflect better current market conditions for both physician ownership practices and self-employed physicians. It will also enable the MEI to be updated more frequently. The change would not impact the overall MPFS spending but could result in significant changes to payment for particular specialties. CMS is not proposing to use the updated MEI data to set payment rates for CY 2023 but is soliciting comments on future use.

To know more about the Impact of the 2023 MPFS Proposed Rule on Neurology Billing click here: http://bit.ly/3Zuoyn9 Contact us at info@medicalbillersandcoders.com888-357-3226.

Comments

Popular posts from this blog

How to Reduce Days in A/R with Smart Denial Management Strategies

How Outsourced Medical Billing Can Improve Your Practice’s Profitability

Is Your Neurology Billing Outsourcing Helping or Hurting You at Year-End?