Category Archives: CMS

Medicare and COVID-19

*Update 03/23/20

Medicare announced this morning that they are waiving all restrictions on telehealth billing to help contain the COVID-19 outbreak. Here is what you need to know. 

  1. Use regular E&M codes for your Medicare patients. 
  2. Use modifier GT to indicate the visit was done via telehealth. **UPDATE – Medicare no longer uses GT modifier. Place of service 02 is enough to indicate telehealth.** 
  3. Use place of service 02 to indicate the visit was done via telehealth
  4. HIPAA restrictions on video technology have been waived. This means that your providers can use Skype, FaceTime, WhatsApp, RingCentral, and other commercially available video conferencing software for the time being.
  5. If using asynchronous video use modifier GQ.

Please encourage all your providers to use telehealth services whenever possible. Keeping ourselves, our patients, and our providers away from sick people is best and easiest way to stop the spread of this illness. For our providers who must still see patients in person, we have a simple suggestion to help keep your patients healthy. 

Instead of having people in your waiting room, have them wait in their cars. Have patients call to check in when they get to your office, and, once a room is ready, call them. An MA or provider can meet them at the front door and take them directly to a room. In between patients, each room can be quickly sanitized.

We can all do our parts to protect the people most vulnerable to this virus. If you have any questions about telehealth in your state or how to bill Medicare or how to add these procedures to your office, please call (909) 610-9524 or email 


Filed under Billing, CMS, COVID-19, Medical Billing, Medicare, Office policy, Telehealth

Heads up for my ophthalmologist friends

Hello my ophthalmologist friends!

Medicare is changing the rules for the 92235 and the 92240. Up until 2017 we would bill two line items of those codes with RT/LT modifiers. According to the new edits, as of 2017 those codes are bilateral. If you separate them and use the RT/LT modifiers your claim will be denied. 

If you already sent them that way, you can use your local Medicare site to do a simple claim correction and get that updated. 

For the FA and the ICG this year, you bill just one line item with no modifiers. And, yes, we will get paid less. 


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Filed under CMS, Medical Billing, Medicare, Modifiers, ophthalmology

Have you heard about MACRA?

MACRA is the law that congress passed regarding Medicare in 2015. I found out about the new legislation a couple weeks ago. And, I have to tell you guys, I am not excited. 

There are going to be a LOT of changes coming for providers once the law goes into effect in 2019 and small practices will be bearing a considerable burden. 

But you all know that I would not be posting scare tactic articles here about something that won’t happen for over two years. So, the statistics that determine whether your providers (or you, if you are a provider) are going to get penalized up to 9% are going to be drawn from self reported data from 2017.

That means that in order not to be penalized in 2019, you and your providers need to make changes as of the 1st of the year. In two months.

New Generation and our sister company, J&J Billing, Inc. are putting on four free one hour trainings. Normally we charge for our webinars, but it is so important that providers know about MACRA and the changes that are coming, that we are waiving the fee. So, fill this form out, and fax it back to me and I will make sure that the online classes we schedule will accommodate everyone .

MACRA Training Availability Form

Fax (909) 367-2922

I will post the final schedule on the blog once we have all the feedback. You will need to email me to sign up for the class. I am working on a fancy-pants sign up sheet for my classes, but it is still quite a work in progress. I am a very good biller and a very bad coder. 

Seriously people, print the form, send it back. This is free. You NEED this information. Tell your friends. 



Filed under CMS, Doctor's Office, MACRA, Medical Billing, Medicare, Online classes

Place of service listing

Hi guys! We recently started billing for a new provider who works in the emergency room. I hadn’t done that kind of billing in years, so I needed to double check the place of service code. And I figure, if I’m searching for it, some of you probably are as well. I found this comprehensive Place of service list from the CMS site. I put it on the links and tools page as well.

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Filed under CMS, Medical Billing, place of service