tci Medicare Compliance & Reimbursement - 2016 Issue 23

Industry Note: Psychiatrist Must Pay Back $908,000 for False E/M Claims

E/M services are a point of contention for many providers, with an oftentimes complex mix of codes and modifiers required to ensure payment. Most physicians innocently send in duplicates or append the wrong modifier, but an Illinois psychiatrist took E/M billing to the next level. The physician was recently ordered to pay CMS back over $908,000 for false claims at long-term care facilities in Illinois. The E/M services reported were either not performed or were not at the level they were claimed under, a Department of Justice (DOJ) news release suggests. In addition to the hefty fine, the...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.


Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Medicare Compliance & Reimbursement +Archives

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.