Betsy Nicoletti

Medical Coding and Compliance Expert, Speaker, Educator, and Auditor

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CMS’s 2021 Physician Fee Schedule Final Rule

Register here

CMS is releasing its 2021 Final Rule late this year, but CodingIntel will bring you the news of updated policies, the conversion factor, and RVUs for E/M services. CMS is under conflicting pressure from specialty societies, because the conversion factor and RVUs determine revenue.

The Final Rule will also bring welcome and unwelcome news about telehealth after the end of the public health emergency. CMS proposed new HCPCS codes for virtual communications by clinicians who cannot bill an E/M services.  And, we’ll find if they have finalized their long proposed add-on HCPCS code for complexity in an E/M service or tabled it.  Finally, CMS is clarifying its interpretation of some of the rules for remote monitoring.

One CMS/CPT disagreement is the use of prolonged care 99417. This 15 minute prolonged care code can only be used with codes 99205 and 99215 after a full 15 minutes are spent. But, do we start the clock at the minimum time range or the maximum time range for the based code? CMS and CPT disagree. Let’s see what the Final Rule has to say.

After the presentation, participants will be able to:

  • Identify current telehealth services that will not be used after the public health emergency ends
  • State CMS’s policy on prolonged services code 99417
  • Describe the new add-on code, if CMS implements it

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“My organization approached Betsy Nicoletti because we had providers failing coding audits.

Betsy’s name is out there in the coding world as a leader in the field and wanted the best for our providers.

Betsy works with the organization to set up webinars for our new provider on boarding training process (which according to them has been most beneficial), as well as subsequent auditing to ensure provider engagement and understanding.

Betsy’s one on one approach has helped the organization overall by the specialized attention to our specific needs.

I appreciate Betsy’s tactful approach with the providers to lessen their concerns as it relates to proper coding. She is up to date on all of the current changes in coding and maintains the communication whenever warranted.

Overall I have found the experience of working with Betsy as positive and educational. I would not hesitate to recommend Betsy to any organization that needs to improve their coding practices and improve success rates from outside auditing.”

Julie D., LPN
Clinical Performance/Operations Manager

• Develop agenda with Betsy*
• Betsy will customize presentation and prepare learning materials
• 90 minute Zoom, live education session
• 30 days Q&A follow up
• Recording of session to show new hires
• Interactive: everyone hears the same thing and can ask questions

*Betsy’s area of expertise doesn’t include all procedural coding – email to set up a time to discuss your needs