APC and MPFS Update for CY 2016

Event Information
Product Format
Prerecorded Event
Presenter(s)
Conference Date
Tue, Dec 08, 2015
Length
90 minutes
Product Description

Understand the Final Changes in 2016 to APC, GSP, MPFS and the future of APC and MPFS

OPPS, in the form of APCs, is now being significantly changed.  The final changes for 2016 continue to involve significantly increase packaging in several forms. Further changes for device dependent APCs along with changes generated to by cost reporting changes. Besides composite APCs, we now have comprehensive APCs. MPFS also continues to evolve with changes each year. CMS has indicated that the global surgical package (GSP) is going to be discontinued among other changes in the MPFS.

Join expert speaker Duane C. Abbey to get an understanding of APC and MPFS updates for 2016.

Expert Speaker Duane C. Abbey will discuss

  • Why haven’t APCs stabilized so that the year changes are minimal?
  • What does the increased bundling under APCs mean for our hospital?
  • Are there new special compliance concerns?
  • What are the general trends for the evolution of APCs?
  • What is the difference between composite versus comprehensive APCs?
  • How is CMS viewing add-on codes for payment purposes?
  • What is all the fuss about status indicators?
  • Why is the conversion factor for MPFS so controversial?
  • Whether changes are being made to telehealth services?
  • What is happening with chronic care management services?
  • How can I assess the impact of the MPFS changes on our clinic?

Learning Objectives

  • To review the many proposed and finalized changes to APCs for 2016.
  • To recognize the general trends for APCs with particular attention to increased bundling.
  • To understand how recent changes in the cost reporting process affect APCs payments.
  • To understand the complex nature of APCs and associated compliance issues including RAC concerns.
  • To understand the difference between composite and comprehensive APCs.
  • To review the possible impact of the proposed change on high impact areas such as observation, the Emergency Department, interventional radiology and associated areas.
  • To review changes to and trends for the Provider-Based Rule (PBR).
  • To discuss anticipated future changes and directions for APCs.
  • To review changes to the MPFS for CY2016.
  • To appreciate the importance of the conversion factor and the relationship to the SGR (Sustainable Growth Rate).
  • To review proposed changes in the RVUs for selected physician specialties.
  • To discuss the proposed change in the Global Surgical Package (GSP).
  • To briefly discuss associated policy areas such as physician quality reporting and the physician compare website.
  • To review changes in associated payment systems and services such as telehealth, anesthesia and the ambulance fee schedule (AFS).

Session Highlights

  • Review of APC Final Changes for CY2016
    • Coding/Grouping Changes
    • E/M Coding
    • Recalibration of APC Weights
    • On-Going Problem Areas
    • Cost Report Changes – Charge Compression
    • Drugs and Biologics
    • Cost Outliers
    • Interventional Radiology
    • Observation
    • Inpatient-Only Procedures
    • Commenting to the Proposed Changes
  • APC Trends
    • Increased Bundling and Packaging
    • Shifts In Realigning Payments
    • Development of Comprehensive APCs
    • Policy and Interpretive Changes
    • Impacts of CPT/HCPCS Changes
  • Provider-Based Clinic Changes
    • CMS Information Collection for Off-Campus Clinics
      • PO Modifier on UB-04
      • New Place of Service 19 on CMS-1500
    • Projecting the Future of Provider-Based Clinics
  • Changes Being Made to MPFS/RBRVS for CY2016
    • RVU Changes
    • Conversion Factor and the SGR
    • Site-of-Service Considerations
    • Changes in GPCIs
    • Facility vs. Non-Facility Practice Expense RVUs
    • Radiation Oncology
    • Future Changes and Trends
  • Global Surgical Package (GSP)
    • GSP Basics
    • Problem Area for Physicians to Report Correctly
    • Discontinuing 10-Day and 90-Day Global Periods
    • Possibly Impacts on Physicians and Clinics
    • Commenting to the Proposed Changes
  • Impact on Related Areas
    • Non-Physician Practitioners
    • Other Medicare Payment Systems
    • Physician Supervision Requirements
  • The Future for APCs and the MPFS

Who should attend?

  • Outpatient Clinical Staff
  • Nursing Staff
  • Physicians
  • Outpatient Departmental Managers
  • Nurse Auditors
  • ED Nursing Staff
  • Provider-Based Clinic Nursing Staff
  • Coding Personnel
  • Coding, Billing and Claims Transaction Personnel
  • Internal Auditing Personnel
  • Financial Analysts
  • Compliance Personnel
  • Cost Accounting Personnel
  • Chargemaster Coordinators
  • Cost Reporting Personnel
  • Other Interested Personnel

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Order Below or Call 1-866-458-2965 Today

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Phone

1-866-458-2965

Fax

1-919-287-2643

About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....   More Info
More Events By The Speaker

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