Category: ROI

CMS Finalizes Remote Patient Monitoring Regulations in Final Rule: 7 Takeaways

CMS released the 2021 physician fee schedule Dec. 1 with expanded telehealth services, remote physiologic monitoring updates and an extension for telecommunications tech supervision. Seven takeaways: 1. CMS clarified its payment policies related to the remote physiologic monitoring services for CPT codes 99453, 99454, 99091, 99457 and 99458, which were finalized in recent years. These...

CMS Finalizes Calendar Year 2021 Payment and Policy Changes for Home Health Agencies – Summary

CMS released the 2021 home health final rule on Thursday, October 29, 2020.  There were minimal changes compared to the home health proposed rule that was released in July 2020. Probably the best news in the rule was the 1.9% aggregate increase (or $390 million) in reimbursement that agencies...

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 – October 15, 2020

As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access the healthcare services they need in as safe a manner as possible. In order to...

Medicaid Telehealth Policies States Can Make Permanent to Ensure Access for Children/Families

In response to the COVID-19 pandemic, state Medicaid agencies have temporarily expanded their telehealth coverage and reimbursement policies in varying degrees. States, providers, advocates and families recognize the important role that telehealth has played in maintaining access to care during the pandemic and are now turning to the difficult...

Executive Summary: Tracking Telehealth Changes State-by-State in Response to COVID-19 – September 2020

As the COVID-19 pandemic continues across the United States, states, payers, and providers are looking for ways to expand access to telehealth services. Telehealth is an essential tool in ensuring patients are able to access the healthcare services they need in as safe a manner as possible. In order to...

MedPAC commissioners hint at telehealth policies that may stick post-COVID-19

Dive Brief: Members of the congressional advisory group Medicare Payment Advisory Commission agree telehealth is here to stay, but are concerned about how to improve access without also running up substantial costs in the Medicare program. The group weighed various Medicare telehealth payment policies that could become permanent after...

CMS Releases E&M Updates, Expands Telehealth, Makes ACO Changes

Among the changes announced this week include the expanded use of telehealth in Medicare, giving payment parity to hospital outpatient surgery centers, simplifying evaluation and management codes, and changing performance measures for accountable care organizations (ACOs). Among a swath of proposed policy and payment changes announced this week by...

Trump executive order targets rural telehealth expansion

The executive order would call on the Department of Health and Human Services to develop a new pilot payment model for rural hospitals, and would set up a task force to improve broadband infrastructure in rural communities. For the past few months, policymakers from the states to Congress have...

Top 10 Medicare Remote Patient Monitoring (RPM) FAQs for 2021

On August 3, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a number of clarifications and proposals on remote patient monitoring (RPM) services reimbursed under the Medicare program. The changes, part of the advance copy of CMS’ proposed 2021 Physician Fee Schedule, are intended to clarify CMS’ position...

Telehealth Coding Guide for Billing

There’s nothing more frustrating than rendering a service and not being paid. Nuanced coding rules are difficult to understand, and physicians aren’t taught this information in medical school. Still, health care is a business. As business owners, physicians need to know how they’re paid, including what codes to use,...

CMS Proposes New Medicare Changes in Telehealth for 2021

On August 3, 2020, the Centers for Medicare and Medicaid Services (CMS) issued the advance copy of its proposed 2021 Physician Fee Schedule rule, which contains new telehealth services covered under Medicare.  Compared to last year, where CMS made only minor additions to telehealth services, the changes proposed for 2021 are bold...

Proposed Policy, Payment, and Quality Provisions Could Bring Changes to the Medicare Physician Fee Schedule for Calendar Year 2021

On August, 3 2020, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces and solicits public comments on proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, on or after January 1, 2021. The calendar year (CY)...

A Quick Reference Guide to Remote Patient Monitoring During the COVID-19 Pandemic

Remote Patient Monitoring (RPM) is real-time or near real-time evaluation of a patient’s clinical status outside of a traditional healthcare setting. RPM leverages wireless devices (e.g., weight scale, blood pressure monitor), often integrated with a software platform, to monitor patients’ health status. Providers can use RPM to manage patients...
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