CMS

In 2002, an OIG report found that Medicare inappropriately reimbursed podiatrists for Routine Foot Care Services that were found to be medically unnecessary and insufficiently documented. Since the OIG had not reviewed podiatry services since that report back in 2002, an audit was conducted to determine whether these compliance issues continued to exist during the subsequent audit period, 2019 and 2020. The audit examined whether podiatrists’ claims for Routine Foot Care Services related to a covered systemic condition complied with Medicare’s requirements. Of the 100 claims that were sampled, 49 claims for Routine Foot Care Services related to a covered systemic condition did not comply with Medicare requirements. As a result of the audit, the OIG opined that CMS’s oversight may not have been sufficient to prevent improper payments. The OIG estimated that of the $18.2 million paid by Medicare during the audit period, approximately $4.4 million did not comply with Medicare’s requirements.

In 2019, the OIG performed an audit of claims that were billed by podiatrists for E/M services. The audit examined whether podiatrists’ claims for E/M services billed with the 25 modifier, which indicates that the E/M service was significant and separately identifiable from a minor surgical procedure billed on the same date of service, one that has a postoperative global period of 0 or 10 days, complied with Medicare’s guidelines. One hundred (100) claims were sampled, and it was found that forty-four (44) claims did not comply with Medicare’s guidelines. The OIG estimated that $39.6 million of the $222.5 million paid by Medicare during the audit period was inappropriate. It was found that during the audit period, CMS’s oversight may not have been sufficient to prevent improper payments.

What is a UPIC Audit and How Serious is this Audit?

The Centers for Medicare & Medicare Services (CMS) has released Merit-based Incentive Payment System (MIPS) payment adjustment information for the 2024 performance period/2026 MIPS payment year.

What Is This Code? When Is It Used? Is it Appropriate to be used in Podiatry?

CMS Proposes Physician Payment Rule to Significantly Cut Spending Waste, Enhance Quality Measures, and Improve Chronic Disease Management for People with Medicare.

The Doctors and Clinicians Preview Period is open officially as of today, Tuesday, May 27, 2025. You can now preview your 2023 Quality Payment Program (QPP) performance information before it appears on the profile pages of clinicians and groups on the Medicare.gov compare tool and in the Provider Data Catalog (PDC). You can access the secure preview on the QPP website.

2024 is winding down and we should be getting ready to report our 2024 performance to CMS. A common question that keeps popping up is: “Am I required to report MIPS for 2024?”

The Centers for Medicare & Medicaid Services (CMS) and Wisconsin Physicians Service Insurance Corporation (WPS) are notifying people whose protected health information or other personally identifiable information (PII) may have been compromised in connection with Medicare administrative services provided by WPS. WPS is a CMS contractor that handles Medicare Part A/B claims and related services for CMS.

CHECK YOUR FEEDBACK REPORTS NOW! You have until October 11, 2024 to request a targeted review. Now Available: 2023 MIPS Performance Feedback, 2023 MIPS Final Score, and 2025 MIPS Payment Adjustment Information