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

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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 ...

Proposed Updates for Skilled Nursing Facility Quality Reporting Program (SNF QRP)

 Proposed Updates for Skilled Nursing Facility Quality Reporting Program (SNF QRP)

On April 11, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update Medicare payment policies and rates for skilled nursing facilities (SNF) for the year 2023. This SNF PPS (Skilled Nursing Facility Prospective Payment System) includes proposals for the SNF Quality Reporting Program (QRP) and the SNF Value-Based Program (VBP) for FY 2023 and future years. This proposed rule CMS is publishing this proposed rule consistent with the legal requirements to update Medicare payment policies for nursing homes on an annual basis. 

What is the SNF QRP?

The SNF QRP creates SNF quality reporting requirements, as mandated by the Improving Medicare Post-Acute Care Transformation Act of 2014 (IMPACT Act).  Every year, by October 1, CMS publishes the quality measures SNFs must report. The IMPACT Act requires the reporting of standardized patient assessment data with regard to quality measures and standardized patient assessment data elements. The Act requires the submission of data pertaining to quality measures, resource use, and other domains. In addition, the IMPACT Act requires assessment data to be standardized and interoperable to allow for the exchange of data among post-acute providers and other providers. The IMPACT Act intends to standardize post-acute care data to improve Medicare beneficiary outcomes through shared-decision making, care coordination, and enhanced discharge planning. If an SNF fails to submit the required quality data, the SNF will be subject to a two percentage (2%) point reduction in the Annual Payment Update (APU) for the applicable performance year.

To know more about Proposed Updates for the SNF QRP click here: http://bit.ly/3Zuoyn9 Contact us at info@medicalbillersandcoders.com888-357-3226.

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