E/M Complexity Code

January 15, 2025

$100,000 Penalty Against Mental Health Center – Failure to Provide Timely Access to Records

The Office of Civil Rights (OCR) imposed a $100,000 penalty against a California mental health facility, Rio Hondo Community Mental Health Center. The violation was levied against the practice for…

January 15, 2025

Virginia Practice Pays $2M For False Documentation

A hospital in Virginia agreed to pay $2,378,731.06 for submitting claims to Medicaid that were improperly modified by the request of the practice’s employee. Here is the press release. This is a…

January 15, 2025

Verification of Benefits – Are Payers Bound by Those Calls?

Verification of Benefits (“VOB”) occurs nearly daily, and the practice relies on the information provided by the payer. Yet, if the payer gets it wrong, can the practice still force reliance on…

January 15, 2025

G2211 Can be Reported with Preventive Services

CMS Issued Transmittal 13015 on December 23, 2024, covering expanded reporting of G2211. CMS allows payment for G2211 when certain Part B Preventive Services are provided on the same day,…

CMS Update

March 15, 2024

G2211 Visit Complexity Code: Simplified Requirements for Reimbursement

G2211 visit complexity is now payable. We explain the requirements in simplified easy to understand rules to ensure proper reimbursement. The moratorium on Medicare payment for G2211 issued under…