Primary care physicians throughout the country struggle to maximize Medicare billing codes. In fact, a recent study from the American College of Physicians (ACM) illustrated that if half of eligible Medicare patients received preventive and coordination services, there would be a significant increase in annual revenue for primary care providers.

CareTrack acts as a practice extension to relieve tasks, such as determining patient eligibility, documentation, billing codes and more.

Since the Medicare Physician Fee Schedule (MPFS) determines reimbursement billing codes, CareTrack provides out-of-office services reflected in additional codes that benefit Medicare patients.

However, the low adoption of the billing codes associated with these preventative and coordination services has caused practices to miss out on additional revenue.

In the ACM study of Medicare billing codes, physicians provided many eligible patients with preventive services. In turn, most physicians did not bill these services along with many coordination services. Practices are losing significant revenue by underutilizing preventive and coordination services codes.

The ACM study examined 34 Medicare billing codes for prevention and coordination services. Eligible services ranged from 8.8% to 100% for individual prevention and coordination services. However, the actual provision of services ranged from 5.0% to 60.6% annually, but the median use of billing codes was only 2.3%.

In this study, physicians provided preventive services of $40,187 in uncollected revenue because of the missed billing codes. Better utilization of preventive services to just half of the eligible patients could result in additional reimbursements of $124,435 annually.

Furthermore, the study shows primary care physicians could receive more than $80,000 in additional annual revenue for providing and billing coordination services for half of all eligible patients. Depending on the code, the increase in revenue per patient visit could result in up to $27.17 per visit.

Primary care practices aren’t benefiting from the full reimbursement potential Medicare offers for providing preventive services to an eligible patient population.

Allow CareTrack to solve Medicare billing issues to increase your revenue. Our patient adherence solution seamlessly works with primary care practices to apply Medicare codes to all eligible patients while giving them the best care possible.

Leave a Reply