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Principal Care Management (PCM) Reimbursement under the 2020 Medicare Physician Fee Schedule
Articles Nixon Law Group Articles Nixon Law Group

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.

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How to Get Paid for Patient "e-Visits" under the 2020 Medicare Physician Fee Schedule
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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.

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Breakthrough Devices: CMS Removes Hurdles and Increases Payments for New Technology Add-On Payments Under the IPPS Final Rule
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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.

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Reimbursement and Practical Considerations for House Call Practices
Articles Nixon Law Group Articles Nixon Law Group

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!

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Considerations for Clinician Contracting – An Employer Perspective
Articles Nixon Law Group Articles Nixon Law Group

Considerations for Clinician Contracting – An Employer Perspective

Having written a series of posts over the years addressing employment contracting from the physician perspective, one of our readers reached out to let us know that Nixon Law Group should, likewise, address physician/clinician employment contracting from the perspective of the healthcare employer.  Considerations for Clinician Contracting – An Employer Perspective…

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7 Common Mistakes Physicians Make When Signing a Physician Employment Contract (and How to Avoid Them)
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7 Common Mistakes Physicians Make When Signing a Physician Employment Contract (and How to Avoid Them)

Smart physicians are not immune from making highly regrettable mistakes when it comes to employment contracts. And unlike in medicine, you don't get the option of trying a new treatment plan if the first one doesn't work. Physicians are educated, and intellectually sophisticated. This means that, even though you weren’t trained to read legal contracts in medical school, courts expect that you have read and fully understand the terms of the contracts you sign. That means that, both during and even after your employment, you're stuck with the contract you sign, so make sure you avoid these common pitfalls.

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How to Get Paid for Remote Interprofessional Consultation between Physicians
Articles Guest User Articles Guest User

How to Get Paid for Remote Interprofessional Consultation between Physicians

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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CMS introduces CPT Codes 99453, 99454, and 99457 to reimburse for Chronic Care Remote Patient Monitoring
Articles Nixon Law Group Articles Nixon Law Group

CMS introduces CPT Codes 99453, 99454, and 99457 to reimburse for Chronic Care Remote Patient Monitoring

The final 2019 Medicare Physician Fee Schedule (the “Rule”), released on November 1st, creates three new codes in the category of Chronic Care Remote Physiologic Monitoring (“CCRPM”) for (1) initial set-up and patient education, (2) initial device supply, and (3) monitoring data and interacting with patients or caregivers.

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