Take Advantage of the Preventative Care Medical Billing Increases

The Centers for Medicare and Medicaid Services updated the healthcare payment amounts for certain medical procedures related to preventative care. The Outpatient Prospective Payment System (OPPS) has ruled in favor of the provider on a few financial issues. There are some medical billing changes implemented in the January 2006 update that will increase your revenue if you use them correctly.

The main medical billing change issued by the Outpatient prospective payment system (OPPS) deals with preventative screening exams. Beginning in January 2006, Medicare will now reimburse at a higher rate for most preventative services provided. For instance: Many patients receive a “Welcome to Medicare” physical. Now, if hospitals provide this service in their outpatient department, the Centers for Medicare & Medicaid Services will issue them 7 percent more payment than they did in 2005.

Another medical billing change for hospitals deals with acute hospital care in rural areas. Beginning in January 2006, these hospitals will now receive 7.1 percent more reimbursement for this type of service, as well as 3.7 percent inflation for acute care hospitals. The Centers for Medicare & Medicaid Services also reduced beneficiaries’ coinsurance rate for any outpatient hospital services.

The Centers for Medicare & Medicaid Services also established a temporary payment add-on for additional IVIG (intravenous immune globulin). Additionally, the outpatient prospective payment system also set a threshold of $1,250 for 2006.

View all Articles by: Melissa Clark, CCS-P