On-Demand: Cents and Sensibility: Navigating PM&R Billing Codes with Finesse-Session Recording

Video Transcription

Video Summary

The recorded session, "Sense and Sensibility, Navigating PM&R Billing and Coding with Finesse," led by Lauren Shapiro and joined by experts Carolyn Millett and Clarice Sin, aims to offer insights into complex billing and coding issues in the field of Physical Medicine and Rehabilitation (PM&R). Key topics include the use of various billing codes, such as the G2211 code for longitudinal care, and clarifications on FS and 25 modifiers. The session emphasizes the significance of understanding G codes and outlines Medicare's role in telehealth and reimbursement practices.<br /><br />Shapiro, Millett, and Sin explore how the use of G2211 can compensate physicians for the time spent on comprehensive care over time. Despite underutilization, Shapiro encourages practitioners to apply this code due to its role in the adjustment of the conversion factor. The session also covers FS modifiers for split-shared visits and the correct application of the 25 modifier, which indicates a separate identifiable evaluation and management service.<br /><br />The speakers address financial aspects, such as the conversion factor, highlighting a cut that impacts RVU reimbursement and urging practitioners to advocate for change. They also delve into telemedicine billing, noting significant changes due to pandemic waivers, which expanded telehealth service coverage. Key barriers to telehealth adoption include reimbursement variability and the need for payer-specific coding compliance.<br /><br />Lastly, the discussion briefly touches on recent valuation changes in acupuncture coding by the AMA's RUC, portraying minimal financial impact but underscoring continual adaptation in the field of PM&R billing and coding.

Keywords

PM&R billing

coding issues

G2211 code

FS modifiers

25 modifier

Medicare telehealth

reimbursement practices

conversion factor

telemedicine billing

acupuncture coding