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New HCPCS codes for OTP’s

Opioid Treatment Programs (OTP’s) have been a hot topic for several years. Among several new codes set to be implemented January 1st are new HCPCS codes specifically for OTP’s. Here are two sequences to be aware of: GYYY1-GYYY3 (office-based treatment) GXXX1-GXX19 (medication-assisted treatment) These new codes will reimburse with bundled payments for the treatment of…



Although the exact reason for denial was not given for this encounter we know this is considered investigational. Most insurances will not pay, it would have to be unlisted-23929. Click below for more information! As a general rule, benefits are payable under Blue Cross and Blue Shield of Alabama health plans only in cases of…


With the Release of the 2020 Physician Fee Schedule & the Final Rule, CMS Confirms the Direction of Upcoming E/M Changes

RT Welter is providing new information regarding E/M changes in 2020. Read the updates below on what is coming next year for coding, along with changes to PCM and CCM. What’s New for 2020 The CY 2020 PFS conversion factor will increase to $36.0896, up to $0.05 from CY 2019.  Three new Telehealth Service codes…


CMS Delays Start of Primary Care Payment Model

CMS’ Innovation Center will delay the start of a new payment model called Primary Care First by a year, according to timeline updates on the model’s information page. Primary Care First, announced in April, was slated to begin in January 2020. Now, it will begin in January 2021. The voluntary model is a set of five-year payment…


2020 ICD‐10‐CM Updates

2019 ICD‐10‐CM updates went into effect on October 1st. These changes will impact encounters for dates of service October 1, 2019 through September 30, 2020. It is imperative that your organization has up‐to‐date coding resources and a keen understanding of the changes that will impact your reimbursement! The new updates can also influence your organization’s…