Blog, Centers for Medicare & Medicaid Services (CMS) - Medicare, Consolidated Appropriations Act (CAA), COVID-19 - Coronavirus, Physician Fee Schedule, Public Health Emergency (PHE), Telehealth 0 comments
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CMS 2024 Proposed Rule Key Takeaways for RPM, RTM & Telehealth
CMS 2024 Proposed Rule Policy Updates On July 13, 2023, the Center for Medicare and Medicaid Services (CMS) released the CMS 2024 Proposed Rule and Medicare Physician Fee Schedule, including possible Medicare payments under the Physician Fee Schedule and other Medicare Part B issues policy updates. While the CMS 2024 proposed rule contained no new CPT […]
CMS Proposes to Extend Telehealth Coverage, Cut Traditional Fee for Service Rates in Physician Fee Schedule Proposed Rule
The 2024 Physician Fee Schedule proposed rule (CMS-1784-P) — released July 13 by the US Centers for Medicare and Medicaid Services (CMS) — extends coverage of a variety of telehealth services at the non-facility reimbursement rate through Dec. 31, 2024, as mandated by Congress in the 2022 Consolidated Appropriations Act. The proposed rule also ensures that the […]
42 CFR § 411.15 – Particular Services Excluded from Coverage.
§ 411.15 Particular services excluded from coverage. Link to an amendment published at 88 FR 53345, Aug. 7, 2023. The following services are excluded from coverage: (a) Routine physical checkups such as: (1) Examinations performed for a purpose other than treatment or diagnosis of a specific illness, symptoms, complaint, or injury, except for screening mammography, colorectal cancer screening […]
CMS Allows States To Extend PHE-Era Flexibilities For HCBS
The U.S. Centers for Medicare & Medicaid Services (CMS) has extended a COVID-19 pandemic-era waiver that will allow home- and community-based service (HCBS) providers to take advantage of flexibilities in their state programs. The Appendix K waiver allowed HCBS providers more wiggle room during emergencies, such as the COVID-19 pandemic. CMS introduced the waiver to […]
Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19
2023: New Federal Developments There were no new federal developments in the last month. 2023: New State-Level Developments State Activity Illinois Illinois passed S.B. 1913, which requires Medicaid FFS and Medicaid managed care plans to provide coverage of mental health services, substance use disorder treatment, and ‘behavioral telehealth services’. Requires Medicaid FFS and Medicaid managed care plans […]
[UPDATED] CMS’ 2024 SNF Final Rule Seen as Insufficient for Payment Rates While Advancing Unfair Measures
The Centers for Medicare & Medicaid Services (CMS) issued a final rule Monday that updates Medicare payment policies and rates for skilled nursing facilities under the Skilled Nursing Facility Prospective Payment System for fiscal year 2024. The federal agency estimates that the aggregate impact of the payment policies in the latest rule would result in […]
CMS Annual Physician Fee Schedule Updates: Effects on Telehealth Services
At a Glance The annual Medicare physician payment rule is upon us, proposed July 13, 2023, for calendar year (CY) 2024 and open for public comment through September 11. Each year, the couple-of-thousand-page rule makes modifications to how Medicare pays physician and nonphysician providers for their services, including for telehealth services. In recent years, the physician […]
CMS Releases CY 24 Medicare Physician Fee Schedule Proposed Rule
The Centers for Medicare & Medicaid Services (CMS) has released the calendar year (CY) 2024 Revisions to Payment Policies Under the Physician Fee Schedule (MPFS) and Other Revisions to Medicare Part B (CMS-1784-P) Proposed Rule, which includes proposals related to Medicare physician payment and the Quality Payment Program (QPP). The Proposed Rule, released on July […]
CY 2024 Medicare Physician Fee Schedule: Extending Telehealth Flexibilities and Seeking Future Policy Input
CMS recently released the CY 2024 Medicare Physician Fee Schedule (MPFS) Proposed Rule (Proposed Rule), which included many noteworthy proposals and clarifications related to Medicare telehealth services and other remote services. Since the COVID-19 Public Health Emergency (PHE) terminated on May 11, 2023, providers and practitioners have sought clarity on the end dates of various waivers and […]
Remote Monitoring: CMS Clarifies Guidance, Proposes Rural Provider Payment, Requests Information on Digital Therapeutics
Over the past several years, the Centers for Medicare and Medicaid Services (CMS) has expanded payment for care management and remote monitoring services in an effort to recognize and pay for non-face-to-face services that improve care coordination for Medicare beneficiaries. In connection with the calendar year 2024 Medicare Physician Fee Schedule (MPFS) proposed rule, CMS […]
CMS’ Proposed Fee Schedule Boosts Payments for Telehealth
CMS proposed changes to the physician fee schedule that would provide physicians with additional compensation to account for balancing telehealth visits with maintaining their physical offices, Politico reported July 17. The proposal would increase the payment rates of healthcare providers for the virtual care they offer Medicare patients remotely. The additional compensation for telehealth services will be […]
CMS RELEASES CY 2024 PHYSICIAN FEE SCHEDULE PROPOSED RULE
On July 13, 2023, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2024 Revisions to Payment Policies Under the Physician Fee Schedule (PFS) and Other Revisions to Medicare Part B [CMS-1784-P] Proposed Rule, which includes proposals related to Medicare physician payment and the Quality Payment Program (QPP). Physicians and other […]
CMS’ Proposed Medicare Physician Fee Schedule Provokes Strong Reactions
Industry reactions have been very mixed to the announcement by the federal Centers for Medicare and Medicaid Services (CMS) of the agency’s proposed physician fee schedule, with many national provider associations blasting the proposed fee schedule, while praising the extension of payment parity for telehealth-delivered patient care. The agency’s announcement was posted to its website on […]
Takeaways From the Proposed 2024 Medicare Physician Fee Schedule, Part 1
The U.S. Centers for Medicare & Medicaid Services has released the proposed 2024 Medicare Part B Physician Fee Schedule, and, as always, it’s a mixed bag of good and not-so-good news. Unfortunately, as in previous years, payment cuts are a part of the proposal. This time around, however, other upsides are more prevalent than they’ve been […]