Posts in CMS Programs
Telehealth in the 2022 Medicare Physician Fee Schedule: Audio-Only Telehealth for Mental Health Made Permanent, and CMS Punts on Remote Direct Supervision

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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Additional Reimbursement for Chronic Care Management and Principal Care Management Finalized in the 2022 MPFS

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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Carrie Nixon in mHealth Intelligence Discussing the 2021 MPFS Reimbursements for RPM

Nixon Gwilt Law’s Managing Partner, Carrie Nixon, was quoted in an article appearing in mHealth Intelligence discussing the January amendments by the Centers for Medicare & Medicaid Services to the 2021 Physician Fee Schedule to clarify reimbursement for remote patient monitoring programs.

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2021 Trends and Opportunities for Healthcare Providers, Digital Health, and Life Sciences Innovators

2020 was the year that showed us all that you can’t truly predict what lays ahead. But, for all the surprises of the last year, the industry didn’t collapse, it accelerated along familiar trend lines. So, after a year like 2020, should we even attempt to predict what will happen in 2021? We say yes. And here’s why…

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Carrie Nixon in mHealth Intelligence Discussing the 2021 Medicare Physician Fee Schedule

Nixon Gwilt Law’s Managing Partner, Carrie Nixon, was quoted in an article appearing in mHealth Intelligence discussing the recent changes to Telehealth and Remote Patient Monitoring with the new 2021 Medicare Physician Fee Schedule (learn about our take here and here).

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Remote Patient Monitoring in the 2021 Medicare Physician Fee Schedule: The good, the bad, and the ugly

On December 1, 2020, the Centers for Medicare and Medicaid Services (“CMS”) released its Final Medicare Physician Fee Schedule for 2021 (the “Final 2021 MPFS”), revising payment policies for services provided to Medicare beneficiaries by medical practitioners. These policies will take effect on January 1, 2021. Read on for insights from Team NGL.

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Behavioral Health Integration Under the 2021 Medicare Physician Fee Schedule Proposed Rule

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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Reimbursement for Virtual Check-ins and e-Visits in the Proposed 2021 Medicare Physician Fee Schedule

On August 3, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released it Proposed Medicare Physician Fee Schedule for CY 2021 (“Proposed MPFS”), seeking to expand reimbursement for Virtual Check-ins and e-Visits as a way of improving access to patient care. CMS proposes seven new HCPCS codes for these “Communication Technology-Based Services” that could be billed by practitioners who cannot bill Evaluation and Management (“E/M”) services independently.

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Carrie Nixon in mHealth Intelligence Discussing the Recent Telehealth Changes

Carrie Nixon, of the Nixon Law Group, said the order calls for “a strategy to improve rural health by improving the communications infrastructure in rural America,” though she notes such a strategy would have to be funded.

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Rebecca Gwilt in Home Health News Discussing the Latest Telehealth News

Nixon Law Group’s Partner, Rebecca Gwilt, was quoted in an article appearing in Home Health News discussing the new CMS proposed rules and how the supposed expansion of telehealth leaves out home health. Home health was largely ignored in the national conversation about supporting the expansion of telehealth

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The Future of Telehealth is Now in Sight: CMS’ Proposed Changes to the Medicare Physician Fee Schedule for CY 2021

On Monday, August 3, 2020, the Centers for Medicare & Medicaid Services (“CMS”) released the 2021 Medicare Physician Fee Schedule Proposed Rule (the “2021 Proposed Rule”). In the healthcare industry, the Medicare Physician Fee Schedule or “MPFS” is arguably the most prominent force shaping the industry on an ongoing basis. Each year, CMS releases a Proposed Rule mid-summer to give stakeholders a first look at what is potentially to come for the following year. Stakeholders have an opportunity to comment on those proposals, CMS reads the comments it receives, and then based on those comments CMS updates its proposals and releases a Final Rule.

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Remote Patient Monitoring in the 2021 Proposed Medicare Physician Fee Schedule

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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Op-ed by Carrie Nixon in The Hill: 5 Actions to Fuel the Digital Health Momentum

Nixon Law Group’s Managing Partner, Carrie Nixon, was quoted in an op-ed for The Hill discussing 5 actions to fuel the digital health momentum. "The COVID-19 public health emergency has forcefully opened the door for widespread adoption of telehealth, remote patient monitoring, and other digital health platforms by patients and providers alike."

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Carrie Nixon on Post-COVID-19 Telehealth Rules and Policies with mHealth Intelligence

Experts Weigh in on Post-COVID-19 Telehealth Rules and Policies. Nixon Law Group’s Managing Partner, Carrie Nixon, was quoted extensively in an article appearing in mHealth Intelligence regarding her views on post-COVID-19 telehealth rules and policies.

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Rebecca Gwilt on the Legal Case for Home Health Telehealth Reimbursement in Home Health Care News

Nixon Law Group’s Partner, Rebecca Gwilt, was quoted extensively in an article appearing in Home Health Care News regarding her views on the legal case for home health telehealth reimbursement.

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