Comparative Billing Reports

Comparative Billing Reports

Comparative Billing Reports (CBRs) are educational tools administered by the Centers for Medicare & Medicaid Services (CMS). They are developed and disseminated under contract by eGlobalTech, a woman-owned Federal services firm based in Arlington, VA.

 

The CBRs are disseminated to the provider community to provide insight into billing trends across regions and policy groups. A/B Medicare Administrative Contractors (MACs) have been producing and disseminating limited numbers of CBRs to targeted providers for many years. CMS has now formalized and expanded the program to a national level. The program also includes a CBR Support Help Desk that providers can contact to ask questions regarding the CBRs. Following the release of each CBR, eGT will hold an educational teleconference or webinar to educate providers on the substance of the CBR and to provide an opportunity for providers to ask questions.

 

The CBR is just one tool that CMS uses in its ongoing efforts to protect the integrity of the Medicare Trust Fund. Other efforts include

 

•  Educating providers about Medicare’s coverage, coding, and billing rules;

•  Reviewing claims before they are paid to assure compliance with coverage, coding, and billing rules (called prepayment review); and

•  Reviewing claims after they are paid (called post-payment review) to identify and collect overpayments made to providers.
 

CMS employs A/B MACs and Durable Medical Equipment (DME) MACs to enroll providers and suppliers into the Medicare program, process claims and bills, educate providers, conduct prepayment review, conduct post-payment review, and perform other tasks in accordance with the specific contract. CMS employs Recovery Audit Contractors (RACs) to perform post-payment review. CMS also learns of improper payment vulnerabilities through reports issued by the Department of Health and Human Services (HHS) Office of the Inspector General (OIG) and the Government Accountability Office (GAO) and data analysis conducted by CMS employees.

CBR201602
: Electrodiagnostic Testing (EDX)

eGlobalTech (eGT) and Palmetto GBA developed and disseminated a national provider Comparative Billing Report (CBR) which focuses on Electrodiagnostic Testing in February 2016. The report contains data-driven tables with an explanation of findings that compare these providers’ billing and payment patterns to those of their peers in their specialty and across the nation.

 

CBR201602 analysis for Electrodiagnostic Testing (EDX) includes Current Procedural Terminology (CPT®) codes 95905, 95907 - 95913, 95860, 95861, 95863 - 95870, 95885 - 95887. The following link opens a document that contains a table of these codes and their descriptions: CBR201602 Billing Codes

CBR201603
: Modifier 25: Internal Medicine

eGlobalTech (eGT) and Palmetto GBA developed and disseminated a national provider Comparative Billing Report (CBR) in February 2016 on internal medicine physicians' use of modifier 25. The report will contain data-driven tables with an explanation of findings that compare these providers’ billing and payment patterns to those of their peers in their state and across the nation.

CBR201603 analysis for Modifier 25: Internal Medicine includes Current Procedural Terminology (CPT®) codes 99211, 99212, 99213, 99214, 99215. The following link opens a document that contains a table of these codes and their descriptions: CBR201603 Billing Codes

Webinar - Physical Therapy

Providers and suppliers received the opportunity to interact directly with content specialists and submit questions about the comparative billing report on Physical Therapy (CBR201511) sponsored by The Centers for Medicare & Medicaid Services (CMS). The presentation was provided by CMS contractor eGlobalTech and its partner, Palmetto GBA.

- (Americas) Eastern Time (US & Canada)

CBR201511
: Physical Therapy

eGlobalTech (eGT) and Palmetto GBA developed and disseminated a national provider Comparative Billing Report (CBR) on Physical Therapy. The CBR focuses on providers with a specialty of physical therapy and contains data-driven tables with an explanation of findings that compare these providers’ billing and payment patterns to those of their peers in their state and across the nation. The goal of these reports is to offer a tool that helps providers better understand applicable Medicare billing rules.

 

CBR201511 analysis for Physical Therapy includes the following Current Procedural Terminology (CPT®) codes: 97001, 97035, 97110, 97112, 97140, 97530, G0283. The following link opens a document that contains a table of these codes and their code descriptions: CBR201511 Billing Codes