In a recent issue of Report on Medicare Compliance, Principal Valerie Rock and Manager Brian Raabe discuss the recent change by the Centers for Medicare & Medicaid Services (CMS) on how transfers of care are billed for global surgeries. The national publication is produced by the Health Care Compliance Association (HCCA) to provide updates on compliance strategies specifically pertaining to Medicare.
In the article, “Global Surgery Changes Take Effect Jan. 1, With More Leeway, Payment for Post-Op Care,” Rock and Raabe discuss the new add-on code, G0559, that slightly increases pay to physicians who take over post-op care and the requirements for the transfer of care.
The changes were finalized in the 2025 Medicare Physician Fee Schedule (MPFS), Raabe explains. Now, CMS is allowing the division of the global surgery package, a comprehensive surgery payment model for pre-op, surgery, and post-op care, when an informal transfer of care is expected. Raabe describes the use of modifiers for pre-op and post-op care as a relaxation of the rule, and the use of G0559 could be a way for CMS to collect data on post-op evaluation and management services.
Rock adds more changes are likely to come regarding the use of the pre-op modifier for stand-alone surgery payment. She adds the use of the new add-on code, G0559, with code, G2211, is unclear.
Read the full article about payment for post-op care that ran on Dec. 23, 2024, on HCCA’s online platform, COSMOS, or access a PDF of the article.
Learn more!
- Rock, Raabe, and other PYA experts thoroughly discuss global surgeries and transfers of care during a recent PYA webinar, “2025 MPFS Final Rule – Part 2.”
- In a previous Report on Medicare Compliance article, Rock and Raabe comment on transfers of care. Read the article, or access a PDF.
If you have questions about billing for transfers of care, MPFS, regulatory requirements, or any other matter related to compliance or strategy and transactions, our executives are happy to help.
