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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.
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
CMS clarifies use of Remote Patient Monitoring during COVID-19 and further expands Telehealth for Physical Therapists, Occupational Therapists, Speech Pathologists, other practitioners
The Center for Medicare and Medicaid Services (“CMS”) has issued a second Interim Final Rule (“IFR2”) that includes additional expansions and clarifications relating to the provision and reimbursement of telehealth, remote patient monitoring, and telephone services during the COVID-19 Public Health Emergency (“PHE”). While these expansions are another step forward for the adoption of digital technologies and services in healthcare, there are additional changes needed in the near-term, as detailed in the summary below.
Telehealth, Virtual Visits, e-Visits, and Remote Care for Nursing Homes during the COVID-19 Public Health Emergency (PHE)
The burden on the staff and residents of long-term care facilities, including nursing facilities and skilled nursing facilities, has increased significantly around the country. The Centers for Medicare and Medicaid Services (CMS), in response to feedback from industry stakeholders, and under new 1135 waiver authorities granted to it in the Coronavirus Preparedness and Response Supplemental Appropriations Act, implemented several policy changes to support long term care facilities, including changes enabling practitioners to remotely provide services to these facilities and to remotely supervise on-site providers.
NEW! Medicare to Reimburse for Acupuncture Services
On January 21, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized a decision (under National Coverage Determination (NCD) 30.3.3) to cover acupuncture for Medicare patients, specifically those with chronic low back pain (cLBP).
Principal Care Management (PCM) Reimbursement under the 2020 Medicare Physician Fee Schedule
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.
How to Get Paid for Patient "e-Visits" under the 2020 Medicare Physician Fee Schedule
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. The 2020 MPFS finalizes six new CPT codes for e-Visits, providing new opportunities for physician practices to be reimbursed for conducting digital health assessments and evaluations for their patients and for remote patient monitoring companies to add these capabilities to their platforms.
CMS Finalizes Changes to Remote Patient Monitoring in the 2020 Medicare Physician Fee Schedule
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.
Nixon Law Group, a leading health law firm, welcomes Faisal Khan, Esq.
Nixon Law Group, a leading health care law firm representing innovative healthcare providers and health technology companies, announced today that Faisal Khan, Esq. has joined the Firm as Senior Counsel. Mr. Khan will be based in Cleveland, Ohio, expanding Nixon Law Group's reach in the Midwest.
An overview of General Data Protection Regulation (GDPR), HIPAA, and what you need to do next
General Data Protection Regulation (GDPR) preparedness should be a priority and we will review the steps you need to take to make sure you’re in compliance. Though the GDPR comes from the European Union, businesses everywhere should apply GDPR principles in practice.
Breakthrough Devices: CMS Removes Hurdles and Increases Payments for New Technology Add-On Payments Under the IPPS Final Rule
Hospitals and medical device manufacturers will both benefit from the Centers for Medicare and Medicaid Services’ (CMS) finalization of the 2020 Inpatient Prospective Payment System (IPPS) Final Rule (“Final Rule”) scheduled to be published on August 16, 2019. In an effort to increase Medicare beneficiaries’ access to innovative medical technologies, CMS has finalized certain changes to the “new technology add-on payment” “(NTAP) application and payment processes under the Final Rule. This change is likely to encourage hospital adoption of new technologies, which is intended to spur innovation and additional investment in these technologies.
New Maryland Telehealth Rules for Psychiatric Nurse Practitioners
Maryland’s Secretary of Health adopted new regulations that lay out standards for the nonclinical practice of teletherapy by certified registered nurse practitioners/psychiatric mental health (CRNP/PMHs) and psychiatric mental health/advanced practice registered nurses (PMH/APRNs).
Nixon Law Group, a Leading Health Law Firm, Welcomes Thomas E. Miller, Esq.
Nixon Law Group, a leading health care law firm representing innovative healthcare providers and health technology companies, announced today that Faisal Khan, Esq. has joined the Firm as Senior Counsel. Mr. Khan will be based in Cleveland, Ohio, expanding Nixon Law Group's reach in the Midwest.
Reimbursement and Practical Considerations for House Call Practices
Are you thinking about starting a new house call practice? There will be things you need to prepare for (and budget for), so Nixon Law Group compiled this information. Note that major concerns include whether commercial clients can reimburse, what kinds of safety needs there are, and Medicare requirements for a “practice location.” Read more below and feel free to contact us with questions!
CMS issues Technical Correction regarding "Incident To" Billing for Remote Patient Monitoring
On March 14, 2019, CMS issued “Technical Corrections” to address errors in the 2019 Final Medicare Physician Fee Schedule (“MPFS”) published on November 23, 2018. One of these corrections addresses “incident to” billing by clinical staff, and has important implications for Remote Patient Monitoring under CPT Code 99457.