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 […]
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 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 […]
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 […]
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 […]
The 2023 Physician Fee Schedule final rule (“Final Rule”), which became effective in January 2023, lists the services and rates for which Medicare will reimburse providers. The Final Rule sets forth updates regarding several of Center for Medicare and Medicaid Service (CMS) key provisions relating to the delivery and reimbursement of Remote Therapeutic Monitoring (RTM), most notably […]
On May 19, 2023, Novitas Solutions and First Coast Options sent an email to certain interested parties, with whom they had engaged following the multijurisdictional contractor advisory committee (CAC) meeting explaining that they have decided to not pursue at this time a local coverage determination for remote physiological monitoring (RPM) and remote therapeutic monitoring (RTM). […]
09 March 2023 by Caroline Reignley (Washington, DC) , Deborah R. Godes (Washington, DC), Michael Ryan (Washington, DC), Dale Van Demark (New York), Marshall Jackson (Washington, DC) and Abby Higgins (London) A recent multijurisdictional contractor advisory committee (CAC) meeting held by six of the seven Medicare Administrative Contractors (MACs) gave stakeholders an initial opportunity to provide feedback on the strength of clinical evidence to support Medicare coverage […]
A recent multijurisdictional contractor advisory committee (CAC) meeting held by six of the seven Medicare Administrative Contractors (MACs) gave stakeholders an initial opportunity to provide feedback on the strength of clinical evidence to support Medicare coverage for remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) services for non-implantable medical devices. We previewed how this […]
By Anuja Vaidya February 24, 2023 – The American Telemedicine Association and Alliance for Connected Care have expressed concerns regarding a Contractor Advisory Committee (CAC) Meeting on remote physiologic monitoring (RPM) and remote therapeutic monitoring (RTM) for non-implantable devices slated to take place on Feb. 28. The meeting, hosted by multiple Medicare Administrative Contractors (MACs), will seek advice on the […]
The lockdowns of the Covid-19 pandemic accelerated the use of communication technology to offer work, education and life resources remotely. The healthcare industry was no different, where services like telehealth provided access to patients during precarious times, increasing in use by 15x the pre-pandemic levels in some states. Remote therapeutic monitoring (RTM) is just one facet of […]
As medicine continues its digital shift, new billing codes are being added next year for specialties like remote therapeutic monitoring and digital ophthalmology. “The [Current Procedural Terminology] code set does move at the pace of medicine, and it continues to evolve and keep pace with all of the changes,” said Leslie Prellwitz, the American Medical […]
On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) issued the 2023 Physician Fee Schedule (PFS) Final Rule. CMS publishes a PFS annually so as to make changes in federal healthcare reimbursement and policy. PFS changes often spill over into the private sector, as private payors typically consult the PFS when evaluating […]
On November 1, 2022, the Centers for Medicare & Medicaid Services (CMS) released the Calendar Year (CY) 2023 Medicare Physician Fee Schedule (PFS) Final Rule. This article highlights noteworthy provisions of the Final Rule related to telehealth and other remote services. Of particular note, the Final Rule contains provisions extending Medicare coverage to additional telehealth services, […]