CMS has finalized the APCM codes for 2025. See what this means for primary care and digital health companies.
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See what the final Medicare Physician Fee Schedule for 2025 has to say about Digital Mental Health Treatment
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Learn about the Office of Inspector General’s new report around remote patient monitoring and the key areas where it misses the mark.
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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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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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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, 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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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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Nixon Law Group’s Managing Partner, Carrie Nixon, was quoted in an article appearing in Internet of Things World Today discussing the future of telehealth.
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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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Nixon Law Group’s Managing Partner, Carrie Nixon, was quoted in an article appearing in Modern Healthcare discussing the Senate HELP Committee hearing on telehealth that took place on June 17, 2020. The article notes general consensus among Committee members on two areas set forth as priorities by the Committee’s Chair, including 1) making permanent the elimination of the originating site and geographic restrictions for Medicare reimbursement of telehealth visits; and 2) maintaining and potentially expanding the list of services that may be provided by telehealth under Medicare, along with the list of types of healthcare providers eligible to provide these services to Medicare beneficiaries.
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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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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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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.
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The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) passed by Congress on March 27, 2020 opened the door for Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) to increase healthcare access to patients in rural and underserved areas by reimbursing for telehealth services to Medicare beneficiaries during the public health emergency (PHE). In addition, CMS has issued non-legislative policy changes and flexibility to address the increased need for remote services for Medicare beneficiaries in rural areas of the country.
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Join us for a webinar to explain the most recent regulatory and reimbursement changes around the Remote Patient Monitoring, Telehealth, e-Visit, and Virtual Check-in CPT codes, during COVID-19, and what those changes mean from a practical perspective.
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