The main difference between MedPAC and CMS estimates of uncorrected coding intensity is that MedPAC’s estimate accounts for the upward trend in coding intensity.

Differential coding by Medicare Advantage plans appeared to have pushed their risk scores higher than traditional Medicare's scores. Those greater risk scores led to $33 billion in extra revenue for ...

Medicare Advantage remains an attractive option for Medicare beneficiaries, and enrollment has increased substantially, by 66 percent in the past six years. Also increasing, it seems, is coding ...

The health insurance industry was caught off guard by the federal government’s recent proposal to keep next year’s payments ...

The Medicare Payment Advisory Commission, an independent federal agency that advises Congress on Medicare, is considering a recommendation to establish national guidelines for hospital emergency ...

An analysis of differential coding patterns between Medicare Advantage (MA) and Traditional Medicare (TM) plans estimated how much coding differs between insurers and how much extra revenue insurers ...

Average physician reimbursement for all hip and knee joint procedures fell more than 30 percent in the past 20 years, according to a study published in The Journal of Arthroplasty. For the study, ...

Paul D. Jacobs ([email protected]), Agency for Healthcare Research and Quality, Rockville, Maryland. There is widespread agreement that taxpayers pay more when Medicare beneficiaries are enrolled in ...

Each year the Centers for Medicare and Medicaid Services (CMS) publishes Part B Medicare Annual Data (BMAD), reporting the usage of CPT codes and Medicare allowed amounts for the prior year. The ...