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PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accountingBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
COMPLIANCE RISK ASSESSMENTS: THE FOUNDATION OF EFFECTIVE Compliance risk assessments are a vital part of an effective compliance program. They should be performed regularly to support the development and implementation of a compliance work plan. These assessments can be performed manually, or with the assistance of specialty software, and can be accomplished by an internal self-assessment paired with PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consulting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
CARES ACT PROVIDER RELIEF FUND Still nothing. Since its January 15, 2021, announcement that the CARES Act Provider Relief Fund (PRF) reporting deadlines would be extended indefinitely, the Department of Health and Human Services (HHS) has not provided an updated reporting timeline. It appears the reporting portal will not be opened any time soon. Nor has HHS provided substantive guidance THE NO SURPRISES ACT: OVERVIEW OF THE NEW FEDERAL The No Surprises Act: Overview of the New Federal Legislation. “Surprise” medical bills have been a problem for patients and providers for many years. Essentially, patients are said to receive a surprise bill when services provided are “out-of-network”—either the facility or the practitioner is not contracted with theirpayer—and
PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accountingBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
COMPLIANCE RISK ASSESSMENTS: THE FOUNDATION OF EFFECTIVE Compliance risk assessments are a vital part of an effective compliance program. They should be performed regularly to support the development and implementation of a compliance work plan. These assessments can be performed manually, or with the assistance of specialty software, and can be accomplished by an internal self-assessment paired with PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consulting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
PYA | CPA & TAX PROFESSIONALS | HEALTHCARE, TECHNOLOGY PYA. Ranked among the nation’s Top 100 largest CPA firms by INSIDE Public Accounting, PYA is also a leader in the percentage of female ownership, is a Top 15 auditor of the nation’s largest health systems, and is consistently ranked as one of the country’s Top 20 healthcare consulting firms by Modern Healthcare. “IN SHAPE FOR SHIPPING OUT? ESTABLISHING AN EXPORT Secure trade and distribution practices, coupled with effective export management and compliance programs, can reduce inappropriate export and reexport diversion and ensure that your products and information will support legitimate global trade movement. REALTY TRUST GROUP RECOGNIZED BY MODERN HEALTHCARE AS ONE Realty Trust Group has been selected by Modern Healthcare as one of the 2021 Best Places to Work in Healthcare. “RTG is known for our people,” says Greg Gheen, President of Realty Trust Group. “As our company has grown to nearly 100 employees across six regional offices, our culture and workplace environment have been key RTG RANKED AMONG TOP HEALTHCARE DEVELOPERS BY MODERN For the third consecutive year, RTG has earned a spot in the top ten of “Top Development Companies” by Modern Healthcare in its 2021 Construction and Design Survey. “This recognition exemplifies our commitment to providing development expertise to our clients across the country from the strategic planning phase through occupancy,” said Joe Krumdieck, Executive Vice LOAN MODIFICATIONS UNDER THE CARES ACT: REVISED COVID-19-Related Loan Modifications Under Section 4013: The Revised Statement indicates that to be an eligible loan under Section 4013, “a loan modification must be (1) related to COVID-19; (2) executed on a loan that was not more than 30 days past due as of December 31, 2019; and (3) executed between March 1, 2020, and the earlier of (A)60
THE NO SURPRISES ACT: OVERVIEW OF THE NEW FEDERAL The No Surprises Act: Overview of the New Federal Legislation. “Surprise” medical bills have been a problem for patients and providers for many years. Essentially, patients are said to receive a surprise bill when services provided are “out-of-network”—either the facility or the practitioner is not contracted with theirpayer—and
AMERICAN RESCUE PLAN ACT EXPANDS PPP ELIGIBILITY On March 11, 2021, President Joe Biden signed into law the American Rescue Plan Act of 2021 (ARPA or Act). The legislation adds an additional $15 billion in new funding for Economic Injury Disaster Loans (EIDL) and $7.25 billion in Paycheck Protection Program (PPP) funding. The Act also expands eligibility for PPP loans and modifies ACT NOW — STARK LAW REVISIONS WILL IMPACT PHYSICIAN GROUP Published February 5, 2021 Act Now — Stark Law Revisions Will Impact Physician Group Practice Compensation Models on January 1, 2022 BSA—WHO CAN BE CTR EXEMPT: PHASE I VS. PHASE II Under Bank Secrecy Act (BSA) regulations, there are essentially two groups of entities that can be exempt from filing a currency transaction report (CTR) under Phase I and Phase II. For this reason, the Financial Crimes Enforcement Network (FinCEN) has established guidelines for determining who fits in each phase. Phase I defines anexempt entity
BRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
CARES ACT PROVIDER RELIEF FUND Still nothing. Since its January 15, 2021, announcement that the CARES Act Provider Relief Fund (PRF) reporting deadlines would be extended indefinitely, the Department of Health and Human Services (HHS) has not provided an updated reporting timeline. It appears the reporting portal will not be opened any time soon. Nor has HHS provided substantive guidance THE NO SURPRISES ACT: OVERVIEW OF THE NEW FEDERAL The No Surprises Act: Overview of the New Federal Legislation. “Surprise” medical bills have been a problem for patients and providers for many years. Essentially, patients are said to receive a surprise bill when services provided are “out-of-network”—either the facility or the practitioner is not contracted with theirpayer—and
PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accountingBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
COMPLIANCE RISK ASSESSMENTS: THE FOUNDATION OF EFFECTIVE Compliance risk assessments are a vital part of an effective compliance program. They should be performed regularly to support the development and implementation of a compliance work plan. These assessments can be performed manually, or with the assistance of specialty software, and can be accomplished by an internal self-assessment paired with PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consulting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
CARES ACT PROVIDER RELIEF FUND Still nothing. Since its January 15, 2021, announcement that the CARES Act Provider Relief Fund (PRF) reporting deadlines would be extended indefinitely, the Department of Health and Human Services (HHS) has not provided an updated reporting timeline. It appears the reporting portal will not be opened any time soon. Nor has HHS provided substantive guidance THE NO SURPRISES ACT: OVERVIEW OF THE NEW FEDERAL The No Surprises Act: Overview of the New Federal Legislation. “Surprise” medical bills have been a problem for patients and providers for many years. Essentially, patients are said to receive a surprise bill when services provided are “out-of-network”—either the facility or the practitioner is not contracted with theirpayer—and
PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accountingBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
COMPLIANCE RISK ASSESSMENTS: THE FOUNDATION OF EFFECTIVE Compliance risk assessments are a vital part of an effective compliance program. They should be performed regularly to support the development and implementation of a compliance work plan. These assessments can be performed manually, or with the assistance of specialty software, and can be accomplished by an internal self-assessment paired with PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consulting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
PYA | CPA & TAX PROFESSIONALS | HEALTHCARE, TECHNOLOGY PYA. Ranked among the nation’s Top 100 largest CPA firms by INSIDE Public Accounting, PYA is also a leader in the percentage of female ownership, is a Top 15 auditor of the nation’s largest health systems, and is consistently ranked as one of the country’s Top 20 healthcare consulting firms by Modern Healthcare. “IN SHAPE FOR SHIPPING OUT? ESTABLISHING AN EXPORT Secure trade and distribution practices, coupled with effective export management and compliance programs, can reduce inappropriate export and reexport diversion and ensure that your products and information will support legitimate global trade movement. REALTY TRUST GROUP RECOGNIZED BY MODERN HEALTHCARE AS ONE Realty Trust Group has been selected by Modern Healthcare as one of the 2021 Best Places to Work in Healthcare. “RTG is known for our people,” says Greg Gheen, President of Realty Trust Group. “As our company has grown to nearly 100 employees across six regional offices, our culture and workplace environment have been key RTG RANKED AMONG TOP HEALTHCARE DEVELOPERS BY MODERN For the third consecutive year, RTG has earned a spot in the top ten of “Top Development Companies” by Modern Healthcare in its 2021 Construction and Design Survey. “This recognition exemplifies our commitment to providing development expertise to our clients across the country from the strategic planning phase through occupancy,” said Joe Krumdieck, Executive Vice LOAN MODIFICATIONS UNDER THE CARES ACT: REVISED COVID-19-Related Loan Modifications Under Section 4013: The Revised Statement indicates that to be an eligible loan under Section 4013, “a loan modification must be (1) related to COVID-19; (2) executed on a loan that was not more than 30 days past due as of December 31, 2019; and (3) executed between March 1, 2020, and the earlier of (A)60
THE NO SURPRISES ACT: OVERVIEW OF THE NEW FEDERAL The No Surprises Act: Overview of the New Federal Legislation. “Surprise” medical bills have been a problem for patients and providers for many years. Essentially, patients are said to receive a surprise bill when services provided are “out-of-network”—either the facility or the practitioner is not contracted with theirpayer—and
AMERICAN RESCUE PLAN ACT EXPANDS PPP ELIGIBILITY On March 11, 2021, President Joe Biden signed into law the American Rescue Plan Act of 2021 (ARPA or Act). The legislation adds an additional $15 billion in new funding for Economic Injury Disaster Loans (EIDL) and $7.25 billion in Paycheck Protection Program (PPP) funding. The Act also expands eligibility for PPP loans and modifies ACT NOW — STARK LAW REVISIONS WILL IMPACT PHYSICIAN GROUP Published February 5, 2021 Act Now — Stark Law Revisions Will Impact Physician Group Practice Compensation Models on January 1, 2022 BSA—WHO CAN BE CTR EXEMPT: PHASE I VS. PHASE II Under Bank Secrecy Act (BSA) regulations, there are essentially two groups of entities that can be exempt from filing a currency transaction report (CTR) under Phase I and Phase II. For this reason, the Financial Crimes Enforcement Network (FinCEN) has established guidelines for determining who fits in each phase. Phase I defines anexempt entity
BRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
PYA WEBINARS
PYA Webinars. At PYA, we believe in education. Knowledge is power, so our learning curve never stops. And we believe in sharing what we learn, because it’s the right thing to do. These webinars and our continuous publishing are why we’re recognized across the country as industry thought leaders. PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated byBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
BRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consultingCAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
PYA WEBINARS
PYA Webinars. At PYA, we believe in education. Knowledge is power, so our learning curve never stops. And we believe in sharing what we learn, because it’s the right thing to do. These webinars and our continuous publishing are why we’re recognized across the country as industry thought leaders. PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated byBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
BRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consultingCAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
REALTY TRUST GROUP RECOGNIZED BY MODERN HEALTHCARE AS ONE Realty Trust Group has been selected by Modern Healthcare as one of the 2021 Best Places to Work in Healthcare. “RTG is known for our people,” says Greg Gheen, President of Realty Trust Group. “As our company has grown to nearly 100 employees across six regional offices, our culture and workplace environment have been key RTG RANKED AMONG TOP HEALTHCARE DEVELOPERS BY MODERN For the third consecutive year, RTG has earned a spot in the top ten of “Top Development Companies” by Modern Healthcare in its 2021 Construction and Design Survey. “This recognition exemplifies our commitment to providing development expertise to our clients across the country from the strategic planning phase through occupancy,” said Joe Krumdieck, Executive Vice LOAN MODIFICATIONS UNDER THE CARES ACT: REVISED COVID-19-Related Loan Modifications Under Section 4013: The Revised Statement indicates that to be an eligible loan under Section 4013, “a loan modification must be (1) related to COVID-19; (2) executed on a loan that was not more than 30 days past due as of December 31, 2019; and (3) executed between March 1, 2020, and the earlier of (A)60
THE NO SURPRISES ACT: OVERVIEW OF THE NEW FEDERAL The No Surprises Act: Overview of the New Federal Legislation. “Surprise” medical bills have been a problem for patients and providers for many years. Essentially, patients are said to receive a surprise bill when services provided are “out-of-network”—either the facility or the practitioner is not contracted with theirpayer—and
PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. ACT NOW — STARK LAW REVISIONS WILL IMPACT PHYSICIAN GROUP Published February 5, 2021 Act Now — Stark Law Revisions Will Impact Physician Group Practice Compensation Models on January 1, 2022 BSA—WHO CAN BE CTR EXEMPT: PHASE I VS. PHASE II Under Bank Secrecy Act (BSA) regulations, there are essentially two groups of entities that can be exempt from filing a currency transaction report (CTR) under Phase I and Phase II. For this reason, the Financial Crimes Enforcement Network (FinCEN) has established guidelines for determining who fits in each phase. Phase I defines anexempt entity
CAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
MERLE GLASGOW
Merle Glasgow has more than two decades of executive management and operational leadership experience. His expertise in business development, sales and marketing management, strategic partnerships, corporate training, investment strategies, and investor relations has allowed him to successfully manage top-line growth strategies across multiple industries. CLOSELY HELD CORPORATION SHAREHOLDER COMPENSATION—ARE YOU The inevitable and sometimes uncomfortable conversation about compensation—some approach it with anticipation, others with dread. In most instances, the issue is relatively straightforward—employers offer and pay salaries they deem appropriate. However, for shareholders in closely held corporations, the issue becomes more sensitive, particularly where the Internal RevenuePYA WEBINARS
PYA Webinars. At PYA, we believe in education. Knowledge is power, so our learning curve never stops. And we believe in sharing what we learn, because it’s the right thing to do. These webinars and our continuous publishing are why we’re recognized across the country as industry thought leaders. PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated byBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
BRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consultingCAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
PYA WEBINARS
PYA Webinars. At PYA, we believe in education. Knowledge is power, so our learning curve never stops. And we believe in sharing what we learn, because it’s the right thing to do. These webinars and our continuous publishing are why we’re recognized across the country as industry thought leaders. PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated byBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
BRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consultingCAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
REALTY TRUST GROUP RECOGNIZED BY MODERN HEALTHCARE AS ONE Realty Trust Group has been selected by Modern Healthcare as one of the 2021 Best Places to Work in Healthcare. “RTG is known for our people,” says Greg Gheen, President of Realty Trust Group. “As our company has grown to nearly 100 employees across six regional offices, our culture and workplace environment have been key RTG RANKED AMONG TOP HEALTHCARE DEVELOPERS BY MODERN For the third consecutive year, RTG has earned a spot in the top ten of “Top Development Companies” by Modern Healthcare in its 2021 Construction and Design Survey. “This recognition exemplifies our commitment to providing development expertise to our clients across the country from the strategic planning phase through occupancy,” said Joe Krumdieck, Executive Vice LOAN MODIFICATIONS UNDER THE CARES ACT: REVISED COVID-19-Related Loan Modifications Under Section 4013: The Revised Statement indicates that to be an eligible loan under Section 4013, “a loan modification must be (1) related to COVID-19; (2) executed on a loan that was not more than 30 days past due as of December 31, 2019; and (3) executed between March 1, 2020, and the earlier of (A)60
THE NO SURPRISES ACT: OVERVIEW OF THE NEW FEDERAL The No Surprises Act: Overview of the New Federal Legislation. “Surprise” medical bills have been a problem for patients and providers for many years. Essentially, patients are said to receive a surprise bill when services provided are “out-of-network”—either the facility or the practitioner is not contracted with theirpayer—and
PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. ACT NOW — STARK LAW REVISIONS WILL IMPACT PHYSICIAN GROUP Published February 5, 2021 Act Now — Stark Law Revisions Will Impact Physician Group Practice Compensation Models on January 1, 2022 BSA—WHO CAN BE CTR EXEMPT: PHASE I VS. PHASE II Under Bank Secrecy Act (BSA) regulations, there are essentially two groups of entities that can be exempt from filing a currency transaction report (CTR) under Phase I and Phase II. For this reason, the Financial Crimes Enforcement Network (FinCEN) has established guidelines for determining who fits in each phase. Phase I defines anexempt entity
CAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
MERLE GLASGOW
Merle Glasgow has more than two decades of executive management and operational leadership experience. His expertise in business development, sales and marketing management, strategic partnerships, corporate training, investment strategies, and investor relations has allowed him to successfully manage top-line growth strategies across multiple industries. CLOSELY HELD CORPORATION SHAREHOLDER COMPENSATION—ARE YOU The inevitable and sometimes uncomfortable conversation about compensation—some approach it with anticipation, others with dread. In most instances, the issue is relatively straightforward—employers offer and pay salaries they deem appropriate. However, for shareholders in closely held corporations, the issue becomes more sensitive, particularly where the Internal RevenuePYA WEBINARS
PYA Webinars. At PYA, we believe in education. Knowledge is power, so our learning curve never stops. And we believe in sharing what we learn, because it’s the right thing to do. These webinars and our continuous publishing are why we’re recognized across the country as industry thought leaders. PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated byBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
BRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consultingCAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
PYA WEBINARS
PYA Webinars. At PYA, we believe in education. Knowledge is power, so our learning curve never stops. And we believe in sharing what we learn, because it’s the right thing to do. These webinars and our continuous publishing are why we’re recognized across the country as industry thought leaders. PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated byBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
BRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consultingCAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
LOAN MODIFICATIONS UNDER THE CARES ACT: REVISED COVID-19-Related Loan Modifications Under Section 4013: The Revised Statement indicates that to be an eligible loan under Section 4013, “a loan modification must be (1) related to COVID-19; (2) executed on a loan that was not more than 30 days past due as of December 31, 2019; and (3) executed between March 1, 2020, and the earlier of (A)60
THE NO SURPRISES ACT: OVERVIEW OF THE NEW FEDERAL The No Surprises Act: Overview of the New Federal Legislation. “Surprise” medical bills have been a problem for patients and providers for many years. Essentially, patients are said to receive a surprise bill when services provided are “out-of-network”—either the facility or the practitioner is not contracted with theirpayer—and
PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. ACT NOW — STARK LAW REVISIONS WILL IMPACT PHYSICIAN GROUP Published February 5, 2021 Act Now — Stark Law Revisions Will Impact Physician Group Practice Compensation Models on January 1, 2022CAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
BSA—WHO CAN BE CTR EXEMPT: PHASE I VS. PHASE II Under Bank Secrecy Act (BSA) regulations, there are essentially two groups of entities that can be exempt from filing a currency transaction report (CTR) under Phase I and Phase II. For this reason, the Financial Crimes Enforcement Network (FinCEN) has established guidelines for determining who fits in each phase. Phase I defines anexempt entity
MERLE GLASGOW
Merle Glasgow has more than two decades of executive management and operational leadership experience. His expertise in business development, sales and marketing management, strategic partnerships, corporate training, investment strategies, and investor relations has allowed him to successfully manage top-line growth strategies across multiple industries. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. No portion of this white paper may be used or duplicated byany person
LONGTIME HOSPITAL INDUSTRY EXPERT KATHY REEP JOINS PYA Longtime Hospital Industry Expert Kathy Reep Joins PYA. PYA, a leading healthcare consulting and certified public accounting firm, is pleased to announce the arrival of Senior Manager Kathy Reep to the firm. PYA, P.C. has announced Kathy Reep has joined the firm as Senior Manager of Business Development effective September 23, 2019. CLOSELY HELD CORPORATION SHAREHOLDER COMPENSATION—ARE YOU The inevitable and sometimes uncomfortable conversation about compensation—some approach it with anticipation, others with dread. In most instances, the issue is relatively straightforward—employers offer and pay salaries they deem appropriate. However, for shareholders in closely held corporations, the issue becomes more sensitive, particularly where the Internal RevenuePYA WEBINARS
PYA Webinars. At PYA, we believe in education. Knowledge is power, so our learning curve never stops. And we believe in sharing what we learn, because it’s the right thing to do. These webinars and our continuous publishing are why we’re recognized across the country as industry thought leaders. PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated byBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
BRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consultingCAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
PYA WEBINARS
PYA Webinars. At PYA, we believe in education. Knowledge is power, so our learning curve never stops. And we believe in sharing what we learn, because it’s the right thing to do. These webinars and our continuous publishing are why we’re recognized across the country as industry thought leaders. PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated byBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
BRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consultingCAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
LOAN MODIFICATIONS UNDER THE CARES ACT: REVISED COVID-19-Related Loan Modifications Under Section 4013: The Revised Statement indicates that to be an eligible loan under Section 4013, “a loan modification must be (1) related to COVID-19; (2) executed on a loan that was not more than 30 days past due as of December 31, 2019; and (3) executed between March 1, 2020, and the earlier of (A)60
THE NO SURPRISES ACT: OVERVIEW OF THE NEW FEDERAL The No Surprises Act: Overview of the New Federal Legislation. “Surprise” medical bills have been a problem for patients and providers for many years. Essentially, patients are said to receive a surprise bill when services provided are “out-of-network”—either the facility or the practitioner is not contracted with theirpayer—and
PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. ACT NOW — STARK LAW REVISIONS WILL IMPACT PHYSICIAN GROUP Published February 5, 2021 Act Now — Stark Law Revisions Will Impact Physician Group Practice Compensation Models on January 1, 2022CAROL CARDEN
Carol is a graduate of Western Kentucky University with a Bachelor of Science degree in Accounting. Carol is a Certified Public Accountant (Tennessee), an Accredited Senior Appraiser (business valuation discipline), and a Certified Fraud Examiner. She has sat on various councils and committees with the American Institute of CertifiedPublic
BSA—WHO CAN BE CTR EXEMPT: PHASE I VS. PHASE II Under Bank Secrecy Act (BSA) regulations, there are essentially two groups of entities that can be exempt from filing a currency transaction report (CTR) under Phase I and Phase II. For this reason, the Financial Crimes Enforcement Network (FinCEN) has established guidelines for determining who fits in each phase. Phase I defines anexempt entity
MERLE GLASGOW
Merle Glasgow has more than two decades of executive management and operational leadership experience. His expertise in business development, sales and marketing management, strategic partnerships, corporate training, investment strategies, and investor relations has allowed him to successfully manage top-line growth strategies across multiple industries. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. No portion of this white paper may be used or duplicated byany person
LONGTIME HOSPITAL INDUSTRY EXPERT KATHY REEP JOINS PYA Longtime Hospital Industry Expert Kathy Reep Joins PYA. PYA, a leading healthcare consulting and certified public accounting firm, is pleased to announce the arrival of Senior Manager Kathy Reep to the firm. PYA, P.C. has announced Kathy Reep has joined the firm as Senior Manager of Business Development effective September 23, 2019. CLOSELY HELD CORPORATION SHAREHOLDER COMPENSATION—ARE YOU The inevitable and sometimes uncomfortable conversation about compensation—some approach it with anticipation, others with dread. In most instances, the issue is relatively straightforward—employers offer and pay salaries they deem appropriate. However, for shareholders in closely held corporations, the issue becomes more sensitive, particularly where the Internal RevenuePYA WEBINARS
PYA Webinars. At PYA, we believe in education. Knowledge is power, so our learning curve never stops. And we believe in sharing what we learn, because it’s the right thing to do. These webinars and our continuous publishing are why we’re recognized across the country as industry thought leaders. PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated byBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
BSA—WHO CAN BE CTR EXEMPT: PHASE I VS. PHASE II Under Bank Secrecy Act (BSA) regulations, there are essentially two groups of entities that can be exempt from filing a currency transaction report (CTR) under Phase I and Phase II. For this reason, the Financial Crimes Enforcement Network (FinCEN) has established guidelines for determining who fits in each phase. Phase I defines anexempt entity
BRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consulting LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by $282,775 - PYAPC.COM Fair Market Value Compensation Now Trending Hospitals Hospitalist Compensation Hospitalist Subsidies Why PYA? Physicians Hospitalists U.S. Hospitals currently usingPYA WEBINARS
PYA Webinars. At PYA, we believe in education. Knowledge is power, so our learning curve never stops. And we believe in sharing what we learn, because it’s the right thing to do. These webinars and our continuous publishing are why we’re recognized across the country as industry thought leaders. PROVIDING AND BILLING MEDICARE FOR CHRONIC CARE MANAGEMENT Providing and Billing Medicare for Chronic Care Management Services Updated March 2021 © 2021 PYA, P.C. No portion of this white paper may be used or duplicated byBRAD LESKOVEN
Senior Manager. As a leader in PYA’s Healthcare Services Group, Brad is responsible for developing and coordinating healthcare and specialized tax services. His focus is in providing practical tax planning strategies and solutions for physician practices and closely held businesses. His primary areas of expertise include advisingclients on
BSA—WHO CAN BE CTR EXEMPT: PHASE I VS. PHASE II Under Bank Secrecy Act (BSA) regulations, there are essentially two groups of entities that can be exempt from filing a currency transaction report (CTR) under Phase I and Phase II. For this reason, the Financial Crimes Enforcement Network (FinCEN) has established guidelines for determining who fits in each phase. Phase I defines anexempt entity
BRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING 6 | Providing and Billing Medicare for Remote Patient Monitoring © 2019 PYA, P.C. C. CPT 99453 and 99454 The first two RPM codes, CPT99453 and 99454,
MEDICARE BAD DEBT CHECKLIST AND RECENT CLARIFICATIONS Page 1 (800) 270-9629 hbizic@pyapc.com PYA, P.C. Bayport Plaza 3000 Bayport Drive, Suite 860 Tampa, FL 33607 Holly provides Medicare and Medicaid cost report preparation and consulting LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated by $282,775 - PYAPC.COM Fair Market Value Compensation Now Trending Hospitals Hospitalist Compensation Hospitalist Subsidies Why PYA? Physicians Hospitalists U.S. Hospitals currently usingBRIAN FULLER
Bringing over two decades of strategic advisory experience to PYA and its clients, Brian Fuller has led health systems and provider organizations through multi-faceted projects, including health system/network enterprise growth, strategic options evaluation, mergers-and-acquisitions, clinical service line strategy, and consumer and ambulatory network development. PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT MONITORING Page 7 2021: RPM Care Process CPT Code Service Description Non-Facility Rate Facility Rate 99453 Service Initiation $18.80 Same* 99454 Data Transmission $61.90 Same* 99091 Data Analysis/Interp $53.80 Same 99457 Treatment Mgmt (20 min) $48.30 $29.82 99458 Treatment Mgmt (+20 min) $38.89 $29.49 *Assigned to APC 5012 (Clinic Visit and Related Services); 2021 payment ~ $120. HCC RISK SCORE OPTIMIZATION SCHEMES COME UNDER FIRE Risk adjustment is the process of modifying payments and benchmarks to reflect the degree of illness in a specific patient population. For the Medicare Shared Savings Program (MSSP), the Centers for Medicare & Medicaid Services (CMS) uses a risk adjustment methodology called Hierarchical Condition Categories (HCCs), the same methodology used for the Medicare Advantage program. IMPLEMENTING CMS 2019 E/M DOCUMENTATION GUIDELINES The recently released 2019 Medicare Physician Fee Schedule Final Rule includes new documentation guidelines for office- and outpatient-based evaluation and management (E/M) services effective January 1, 2019.. The Final Rule also details a new payment methodology for E/M services effective January 1, 2021.. As part of its “Patients Over Paperwork” initiative, the Centers for Medicare CERTAIN TRUST AND ESTATE EXPENSES--FULLY DEDUCTIBLE OR NOT New guidance has been issued by the Internal Revenue Service (IRS) addressing costs incurred by estates and trusts. The recent regulation clarifies which expenses are fully deductible and which expenses are limited based on income levels.. The IRS’ criteria for a fully deductible expense is any expense that is both incurred in connection with the administration of the estate or trust and LAND EASEMENTS—GUIDANCE FOR NEW LEASE ACCOUNTING A recent Accounting Standards Update (ASU) addresses land easements and their accounting under the new lease standards. In January 2018, the Financial Accounting Standards Board (FASB) issued ASU 2018-01 Leases: Land Easement Practical Expedient for Transition to Topic 842 in order to provide additional transitional support to entities implementing the new lease accounting PROVIDING AND BILLING MEDICARE FOR REMOTE PATIENT Providing and Billing Medicare for Remote Patient Monitoring and Treatment Management © 2021 PYA, P.C. No portion of this white paper may be used or duplicated bySUSAN THOMAS
Susan has spent nearly three decades working in a variety of managerial and clinical capacities including compliance management, clinical department leadership, provider practice administration, internal audit, quality outcomes, and healthcare advocacy. A former corporate compliance officer and clinical department director, she has a demonstrated record of success in program development and THE ART OF DATA CONVERSION COSTS: WHEN OR WHEN NOT TO The Art of Data Conversion Costs: When or When Not to Expense. Technological advancements allow businesses to take advantage of new efficiencies, improved communication, and robust applications. However, these benefits often bring numerous complexities and issues, such as the accounting treatment of data conversion activities, whichoften
$282,775 - PYAPC.COM Fair Market Value Compensation Now Trending Hospitals Hospitalist Compensation Hospitalist Subsidies Why PYA? Physicians Hospitalists U.S. Hospitals currently using PYA Covid-19 Information Hub PYA: HEALTHCARE CONSULTING, AUDIT & ACCOUNTING* About
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PYA
PYA is a national professional services firm providing deep functional expertise in tax, audit & assurance, and management consulting. PYA helps clients in 50 states derive value amid complex challenges related to federal and state filings, regulatory matters, compliance and risk assessment, business valuations, attestations, litigation support, IT advisory, mergers & acquisitions, and overall financial and business strategy. With long-established roots as a CPA firm, PYA is consistently ranked in the Top 100 largest accounting firms by _INSIDE Public Accounting_ and ranked third in percentage of female ownership, and is a Top 15 auditor of the nation’s largest health systems. PYA is also ranked a Top 20 healthcare consulting firm in the U.S. INSIGHTS & PRACTICAL GUIDANCE Focus on COVID-19 Guidance Published June 3, 2020 ON-DEMAND WEBINAR: SO YOU HAVE A PPP LOAN. NOW WHAT? Focus on COVID-19 Guidance Published May 20, 2020 ON-DEMAND WEBINAR: “GOT A PAYROLL? DON’T LEAVE MONEY ON THETABLE”
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