CMS has finalized the APCM codes for 2025. See what this means for primary care and digital health companies.
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Stakeholders will be glad to know that CMS continued the RTM conversation with stakeholders beyond last year’s 2022 Medicare Physician Fee Schedule Final Rule (the “2022 Rule”) and directly addressed many of our questions and concerns, including NGL’s recommendations to re-visit the overall code structure to better align RTM with Remote Physiologic Monitoring (“RPM”) and other care management services.
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The much-anticipated 2023 Medicare Physician Fee Schedule Proposed Rule from CMS has arrived! More detailed analyses from the Nixon Gwilt Law team will follow, but in the meantime, here are our top takeaways from the 2023 Proposed Rule.
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If you missed our most anticipated webinar of the year, be sure to catch the replay!
On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) finalized the Medicare Physician Fee Schedule for Calendar Year 2022 (the “Final 2022 MPFS” or the “Final Rule”). As we noted in our July article discussing the Proposed 2022 MPFS, CMS made some significant proposed changes to allow for audio-only telehealth in some limited circumstances. In addition, the agency also proposed to enable remote “direct supervision,” which would allow practitioners to supervise clinical staff billing incident to their services as long as they could be available by audio/video communication as necessary.
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In the Final Medicare Physician Fee Schedule (“MPFS”) for 2022 (the “Final Rule”) issued on November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) added five new CPT codes in the categories of Chronic Care Management (“CCM”) and Principal Care Management (“PCM”) and increased reimbursement for already existing codes in the same categories. Despite stakeholder feedback, CMS refrained from making any changes to the existing rules for obtaining beneficiary consent for CCM and PCM.
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On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) released its Final Medicare Physician Fee Schedule for 2022 (the “Final 2022 MPFS”), revising certain payment policies for services provided to Medicare beneficiaries by healthcare practitioners. These policies take effect on January 1, 2022.
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This article examines the new CPT codes for Remote Therapeutic Monitoring as finalized for reimbursement in the 2022 Medicare Physician Fee Schedule, discussing key takeaways and implications for digital health and remote patient monitoring companies.
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This is our take on the approach CMS should follow in improving and finalizing the RTM codes and associated reimbursement that improve patient outcomes and lower the overall cost of care. It is based on our extensive work with remote patient monitoring and care management digital health companies along with the physician practices who use the existing care management codes – including Remote Patient Monitoring (“RPM”), Chronic Care Management, Principal Care Management, and Behavioral Health Integration.
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Join Nixon Gwilt Law’s Carrie Nixon and Kaitlyn O’Connor for a presentation and discussion about Remote Patient Monitoring and other virtual care services, with a particular focus on how these services are addressed in the 2021 Medicare Physician Fee Schedule and what that may mean for business and reimbursement models going forward.
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On Monday, August 3, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released the 2021 Medicare Physician Fee Schedule Proposed Rule (the “Proposed Rule”). The 2021 Proposed Rule includes a new code under the Behavioral Health Integration (“BHI”) Collaborative Care Model (“CoCM”) that, if finalized, would offer reimbursement for a shorter increment of time than had previously been available under BHI.
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Last evening, the Centers for Medicare & Medicaid Services (“CMS”) issued its proposed Medicare Physician Fee Schedule for CY 2021 (the “MPFS”). In addition to a number of important changes relating to the provision and reimbursement of telehealth, the proposed MPFS includes long-awaited clarifications around use of the Remote Patient Monitoring (“RPM”) codes established over the past three years
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The 2020 Medicare Physician Fee Schedule (the “Final Rule”), released on November 1, 2019, finalized two new codes in a new category of reimbursement titled “Principal Care Management” (PCM) Services. The new codes will be effective as of January 1, 2020, and provide reimbursement for managing a patient’s care for a single high-risk disease or complex chronic condition.
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The Centers for Medicare and Medicaid Services (CMS) released the Final Medicare Physician Fee Schedule for CY 2020 (the “2020 MPFS”) on November 1, 2019, finalizing some important changes relating to Remote Patient Monitoring (RPM) services, but leaving many questions unanswered as of yet.
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Beginning January 1, 2019, physicians and other Qualified Healthcare Providers (“QHCPs”) eligible to independently bill for E/M services can obtain standalone reimbursement for Interprofessional Internet Consultations using CPT Codes 99446-99449, 99451, and 99452.
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Last week, Nixon Law Group attended the Virginia Medical Group Management Association (VMGMA)‘s fall meeting in Williamsburg, and we were lucky enough to sit in on a session by the dynamic and talented Elizabeth Woodcock (of Woodcock & Associates). It was a whirlwind session on the key changes in the 2017 MPFS Proposed Rule, and we wanted to pass along all of the juicy details.
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