A multi-million dollar scheme serves as a prime example to the benefits of Fraud, Waste, and Abuse (FWA) protection. The story of a doctor performing an alarmingly high amount of surgeries not typically conducted by their specialty is awakening to the need for robust safeguarding solutions.

CPT provides distinct codes for reporting face-to-face Psychotherapy with two different approaches. Either an Evaluation and Management (E/M) code can be submitted in tandem with a Psychotherapy add-on code, or a standalone Psychotherapy code can be submitted. Press "Read More" to learn how to use these codes appropriately.

On January 1, 2022, CMS’s Place of Service (POS) Workgroup added new POS code 10, with description "Telehealth Provided in Patient’s Home". Simultaneously, the established POS code 02 description was changed to "Telehealth Provided Other than in Patient’s Home".

On February 1, 2022, the AMA released three more specific COVID-19 CPT Vaccine codes for use in reporting vaccination with Pfizer’s latest toxoid of patients between six months to five years of age. Although these codes have been released, they will not be effective until the date an EUA (Emergency Use Authorization) is granted by the FDA.

On May 19, 2021, the Medicare Payment Advisory Commission (MedPac) provided feedback to Congress regarding their opinions on the effectiveness of the overwhelming 200 healthcare policy changes that Congress and CMS instituted during the interval of January through July 2020, in response to the coronavirus public health emergency. Aside from the obvious and necessary benefits of these changes in response to the pandemic, MedPac raises concerns about the detrimental impact in the realm of fraud in healthcare: “…not all actors in the healthcare system are well-intentioned”.