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CMS’ Behavioral Health Strategy: Expanded Incident-to Billing and new BHI code in the proposed 2023 Medicare Physician Fee Schedule
Articles Nixon Law Group Articles Nixon Law Group

CMS’ Behavioral Health Strategy: Expanded Incident-to Billing and new BHI code in the proposed 2023 Medicare Physician Fee Schedule

Implementation of CMS’ Behavioral Health Strategy in 2023: Behavioral Health Integration G-code for Clinical Psychologists and Clinical Social Workers, and Opportunity for Clinical Staff to Provide Behavioral Health Services under General Supervision of Physicians and Non-Physician Practitioners

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Proposed Changes to Remote Therapeutic Monitoring Reimbursement in the Proposed 2023 Medicare Physician Fee Schedule
Articles Nixon Law Group Articles Nixon Law Group

Proposed Changes to Remote Therapeutic Monitoring Reimbursement in the Proposed 2023 Medicare Physician Fee Schedule

Stakeholders will be glad to know that CMS continued the RTM conversation with stakeholders beyond last year’s 2022 Medicare Physician Fee Schedule Final Rule (the “2022 Rule”) and directly addressed many of our questions and concerns, including NGL’s recommendations to re-visit the overall code structure to better align RTM with Remote Physiologic Monitoring (“RPM”) and other care management services.

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Top Six Takeaways from the Proposed 2023 Medicare Physician Fee Schedule: New Remote Monitoring, Behavioral Health, and Chronic Pain Care Management Codes and Telehealth Flexibility Extension
Articles Nixon Law Group Articles Nixon Law Group

Top Six Takeaways from the Proposed 2023 Medicare Physician Fee Schedule: New Remote Monitoring, Behavioral Health, and Chronic Pain Care Management Codes and Telehealth Flexibility Extension

The much-anticipated 2023 Medicare Physician Fee Schedule Proposed Rule from CMS has arrived! More detailed analyses from the Nixon Gwilt Law team will follow, but in the meantime, here are our top takeaways from the 2023 Proposed Rule.

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Pharmacy Innovation Series: the DEA Steps into Telepharmacy Regulation
Articles Nixon Law Group Articles Nixon Law Group

Pharmacy Innovation Series: the DEA Steps into Telepharmacy Regulation

For the first time, the Drug Enforcement Agency (“DEA”) is becoming directly involved in the telepharmacy space, an industry that the DEA has not previously regulated aside from the loose application of its existing regulations governing online pharmacies. Find out what this means for your business and how you can submit comments to the DEA directly in this post.

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3 Key Challenges Facing Tele-dentistry Companies and How to Approach Them
Articles Nixon Law Group Articles Nixon Law Group

3 Key Challenges Facing Tele-dentistry Companies and How to Approach Them

Dentistry is one of a number of clinical specialties that is taking a creative and innovative approach to delivering care using digital health tools. Most of us are now familiar with Byte, SmileDirectClub, and Candid—these companies are pioneers in the space. However, tele-dentistry has far more potential applications than retail clear aligner services. Tele-dentistry entrepreneurs are building solutions for remote examination of sore or swollen teeth and gums, screening for certain oral diseases and cancers, mobile dental hygiene, dental hygiene education, and more.

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

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

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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