Business of Medicine

Protecting Modifier 25

CMA members’ concerns about a recent reimbursement policy change Blue Shield had announced regarding evaluation and management (E/M) services billed with the Current Procedural Terminology (CPT) modifier 25. The new policy would reduce by 50% reimbursement for any non-preventive E/M service appended with modifier 25 and billed with a minor procedure code.

The Time Is Now to Prepare for the Next VBC Wave

VBC (value-based care) is coming to otolaryngology offices within the next five years through the Centers for Medicare and Medicaid Services (CMS) initiatives, and otolaryngology needs strategies for responding to how value, outcomes, and cost will be captured and measured

Court Issues Nationwide Injunction on FTC Rule Banning Noncompetes

On April 23, the FTC issued a final rule banning non-competition agreements. After a roller coaster of litigation and uncertainty that lasted months, the FTC Final Rule was halted by a federal court in Texas, in the form of a nationwide injunction. Now the question looms: What does this mean for current and future physician noncompetes?

Use of Prophylactic Antibiotics in Otolaryngology

Fundamental to medical decision making is the challenging task of weighing the benefits against the risks of any given treatment decision. Clinical guidelines and protocols help with this decision making, which is further informed by physician judgment, particularly when the evidence is weak or lacking.