Do you want to know how many units of each CPT code you billed to the Medicare program and what Medicare paid you in 2012? Do you want to know the same of your competitors? This look-up tool is a searchable database that allows you to look up a provider by National Provider Identifier (NPI), or by name and location. The look-up tool will return information on services and procedures provided to Medicare beneficiaries, including utilization information, payment amounts (allowed amount and Medicare payment), and submitted charges organized by Healthcare Common Procedure Coding System (HCPCS) code. The data covers calendar

National Government Services, Medicare Administrative Contractor for Connecticut and New York, has announced a service-specific prepayment reviews of physical therapy services (CPT codes 97002-97140). This review will impact providers

The U.S. Department of Health and Human Services expects to release an interim final rule in the near future that will include a new compliance date that would require the use of ICD-10 beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015. Stay tuned for further updates when the interim final rule is released.

On May 6, 2014, the Centers for Medicare and Medicaid Services (CMS) published the FY 2015  Skilled Nursing Facility (SNF) proposed rule in the Federal Register. The proposed rule will increase payments to SNF’s by 2% in FY 2015. Regarding therapy services provided in the SNF setting, CMS proposes:  

On May 1, 2014, the Centers for Medicare and Medicaid Services (CMS) released the 2015 fiscal year Inpatient Rehabilitation Facility (IRF) proposed rule. The proposed rule will increase payments to IRF’s by 2.2% in FY 2015. In addition, the proposed rule seeks to:

UnitedHealthcare (UHC) has released an updated coverage determination guideline for speech language pathology services. The effective date of the revised coverage determination guideline is May 1, 2014. In addition, UHC has also provided a sample listing of the ICD-10 CM and/or ICD-10 PCS codes associated with this policy. This list of codes may not be all inclusive and will be updated to reflect any applicable revisions to the ICD-10 code set and/or clinical guidelines outlined in this policy. To view the revised policy and a sample listing of ICD-10 codes, click

Effective April 1, 2014, the Remittance Advice Remark Code (RARC) for successful reporting of PQRS measures has changed. Prior to April 1, 2014 the RARC was

The Centers for Medicare and Medicaid Services (CMS) have issued instructions that revise and update the Appeals of Claim Decisions Manual. Revisions include the following: Definition of spouse The submission of appointment of representative written instruments The handling and reporting of defective or missing appointment instruments Signature requirements for appointment of representative instruments To access the manual and revised/updated instructions, click