Posts in Medicare Physician Fee Schedule
CMS Finalizes APCM Codes for 2025: What it Means for Primary Care and Digital Health Companies
CMS Finalizes APCM Codes for 2025: What it Means for Primary Care and Digital Health Companies

CMS has finalized the APCM codes for 2025. See what this means for primary care and digital health companies.

Read More
Medicare Physician Fee ScheduleCarrie Nixonremote patient monitoring, Telehealth, Medicare, Teleheath, Digital Health, behavioral health integration, mpfs, medicare physician fee schedule, remote therapeutic monitoring, digital health, mental health, telemental health, DMHT, APCM, CMS, MPFS, codes
New Reimbursement Opportunities for Digital Mental Health Treatment in 2025: CMS’ Final Rule
New Reimbursement Opportunities for Digital Mental Health Treatment in 2025: CMS’ Final Rule

See what the final Medicare Physician Fee Schedule for 2025 has to say about Digital Mental Health Treatment

Read More
Remote Monitoring, Medicare Physician Fee ScheduleCarrie Nixonremote patient monitoring, Remote Therapeutic Monitoring, Remote Monitoring, remote care, Telehealth, Medicare, Teleheath, Digital Health, behavioral health integration, mpfs, medicare physician fee schedule, remote therapeutic monitoring, digital health, mental health, telemental health, DMHT
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
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.

Read More
Medicare Physician Fee ScheduleCarrie Nixon, Rebecca Gwilt, Kaitlyn O'Connor, and Casey Papp2023 MPFS, MPFS, medicare, reimbursement, rpm, rtm, ccm, telehealth, Remote Patient Monitoring, remote physiological monitoring, Chronic Care Management, telebehavioral health, telemental health, CMS
Telehealth in the 2022 Medicare Physician Fee Schedule: Audio-Only Telehealth for Mental Health Made Permanent, and CMS Punts on Remote Direct Supervision
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.

Read More
Telehealth, Medicare Physician Fee ScheduleRebecca GwiltTelemedicine, telementalhealth, 2022 Medicare Physician Fee Schedule, 2022, MPFS, Medicare, telemedicine, CMS, 99441, 99442, 99443, CPT, 93797, 93798, G0422, G0423, G2252
Additional Reimbursement for Chronic Care Management and Principal Care Management Finalized in the 2022 MPFS
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.

Read More
Medicare Physician Fee ScheduleKaitlyn O'Connor and Reema TanejaCCM, PCM, Chronic Care Management, Principal Care Management, MPFS, 2022, 2022 Medicare Physician Fee Schedule, medicare physician fee schedule, 99437
Under 2022 Medicare Physician Fee Schedule, Physician Assistants Will Be Paid Directly for Services
Under 2022 Medicare Physician Fee Schedule, Physician Assistants Will Be Paid Directly for Services

On November 2, 2021, the Centers for Medicare and Medicaid Services (“CMS”) released its Final Medicare Physician Fee Schedule for 2022 (the “Final 2022 MPFS”), revising certain payment policies for services provided to Medicare beneficiaries by healthcare practitioners. These policies take effect on January 1, 2022.

Read More
Medicare Physician Fee ScheduleCarrie Nixon and Casey Pappphysician coverage, MPFS, 2022, medicare physician fee schedule
Proposed 2022 MPFS: Expansion in Audio-Only Telehealth, Permanent Remote “Direct Supervision”, and Remaining Opportunities for New Permanent Telehealth Codes
Proposed 2022 MPFS: Expansion in Audio-Only Telehealth, Permanent Remote “Direct Supervision”, and Remaining Opportunities for New Permanent Telehealth Codes

CMS didn’t propose to add any permanent telehealth codes, but did incrementally expand patient access to telehealth in other ways.

Read More
Medicare Physician Fee ScheduleRebecca Gwiltproposed rule, telementalhealth, audio-only reimbursement, chronic pain management, rural health clinics, FQHCs, Opioid treatment programs, telebehavioral health, remote supervision, chronic pain
New Remote Therapeutic Monitoring CPT codes introduced in Proposed 2022 Medicare Physician Fee Schedule
New Remote Therapeutic Monitoring CPT codes introduced in Proposed 2022 Medicare Physician Fee Schedule

On July 13th, the Centers for Medicare and Medicaid Services (“CMS”) released its proposed Medicare Physician Fee Schedule for Calendar Year 2022 (the “2022 Proposed MPFS” or the “Proposed Rule”). In doing so, it recognized five new CPT codes for Remote Therapeutic Monitoring (“RTM”) of “non-physiologic” patient data such as “musculoskeletal system status, respiratory system status, therapy (medication) adherence, and therapy (medication) response” as well as pain. While this new code set is welcomed by advocates for virtual care, the 2022 Proposed MPFS that discusses RTM may raise just as many questions as it answers.

Read More
Remote Monitoring, Medicare Physician Fee ScheduleCarrie Nixon and Kaitlyn O'Connorremote patient monitoring, RPM, Remote Therapeutic Monitoring, RTM, 2022 Medicare Physician Fee Schedule
Carrie Nixon in mHealth Intelligence Discussing the 2021 MPFS Reimbursements for RPM
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.

Read More
Remote Monitoring, Medicare Physician Fee ScheduleCarrie NixonRPM, remote patient monitoring, 2021 MPFS, 2021 Medicare Physician Fee Schedule
Carrie Nixon in mHealth Intelligence Discussing the 2021 Medicare Physician Fee Schedule
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).

Read More
Telehealth, Medicare Physician Fee ScheduleCarrie Nixontelehealth, remote patient monitoring, 2021 MPFS, 2021 Medicare Physician Fee Schedule, rpm, RPM, Carrie Nixon