Abby Moorman advises clients on reimbursement and product commercialization in many settings of care including physician office, outpatient department, ASC, and inpatient hospital.

Abby, a certified professional coder, also has special expertise in CPT®, HCPCS, ICD-9, and ICD-10 coding and payment.

Prior to joining Avalere, Abby served as a production coordinator of the Union Copy Center at the University of Maryland at College Park and prior to that was a case manager at Community Residence.

Abby has a BA in psychology from the University of Maryland at College Park, where she interned at the Center for Children, Relationships, and Culture Laboratory for the Study of Child and Family Relationships.

Authored Content


Recent CMS rulemaking has expanded the opportunity for new drugs and devices to achieve NTAP status, either through the traditional process or via alternative. Manufacturers that are nearing the launch of new technologies, especially in the antimicrobial space, should assess whether their technology may qualify for NTAP. Applications for NTAPs effective in FY 2022 are due this fall.

Proposed policy changes largely address concerns around Medicare’s CAR-T inpatient reimbursement, though raise new questions regarding long-term impact on reimbursement and access to innovative therapies.

Approximately ⅓ of physician services payments are eligible for telehealth reimbursement under Medicare (fee-for-service) FFS through existing Center for Medicare and Medicaid Services (CMS) guidance as of January 2020, in addition to temporary coding guidance specific to COVID-19 effective as of March 1, 2020. Avalere’s analysis highlights the immediate potential for specific physician specialties to utilize telehealth based on temporary flexibilities regarding which procedures are eligible for telehealth reimbursement.

The Centers for Medicare & Medicaid Services (CMS) issued a new Interim Final Rule (IFR) that is intended to allow additional beneficiaries, especially those who are at high-risk, to receive home infusions amid COVID-19 transmission concerns. Specifically, the CMS clarified the definition of “homebound” under the Medicare Home Health Benefit and temporarily suspended enforcement of the National and Local Coverage Determinations (NCD and LCD) related to home infusion services. Uncertainties remain as to how these new flexibilities will be utilized, as well as how these flexibilities could impact treatment outcomes.

New flexibilities for telehealth services in fee-for-service (FFS) Medicare are designed to support ongoing COVID-19 response efforts.

Tune in to hear the second episode in our 3-part series that focuses on CMS’s most recent proposed payment rules. In episode 2, we’ll be focusing on the Medicare Physician Fee Schedule proposed rule, or MPFS, with a focus on proposed changes to E/M and Opioid Use Disorder (OUD) treatment services.

Additional Medicare payment options available for new, high-cost technologies used in the inpatient setting.

Beginning in 2019, CMS will reimburse for 5 codes relating to virtual care delivery and remote monitoring

In its proposed changes to the Medicare Physician Fee Schedule (MPFS) for Calendar Year 2019 (CY2019), the Centers for Medicare & Medicaid Services (CMS) proposes a potentially sweeping change to the way it values physician office and outpatient visits, also known as Evaluation & Management (E/M) codes.