Posts in Medicare Physician Fee Schedule
Remote Patient Monitoring in the 2021 Medicare Physician Fee Schedule: The good, the bad, and the ugly

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.

Read More
Behavioral Health Integration Under the 2021 Medicare Physician Fee Schedule Proposed Rule

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.

Read More
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.

Read More
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.

Read More
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.

Read More
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.

Read More
Proposed 2020 Medicare Physician Fee Schedule offers new reimbursement for Remote Patient Monitoring

On July 29, 2019, the Center for Medicare and Medicaid Services (“CMS”) released its proposed rule for the 2020 Medicare Physician Fee Schedule (the “2020 MPFS”).

Read More
HCPCS Code G2010 reimburses for Remote Evaluation of Patient-Submitted Images and Video

The final 2019 Medicare Physician Fee Schedule, released by CMS on November 1, 2018, includes a new code that physicians may use to bill for remote evaluation of images to determine whether or not an in-person office visit is necessary. Learn more about HCPCS Code G2010 and how it can be used in medical practices.

Read More
How to get Reimbursed for Virtual Check-ins under HCPCS Code G2012

In its Final Rule for the 2019 Medicare Physician Fee Schedule released on Friday, CMS introduced a new code, HCPCS G2012, allowing physicians and other qualified healthcare professionals (“QHCPs”) to be reimbursed for “virtual check-ins” with patients who aren’t sure whether or not their symptoms warrant an in-office visit. Learn more about virtual check-ins and how they can be used by practices.

Read More
MSSP Proposed Rule may mean major changes for Medicare ACOs

CMS recently released a Proposed Rule suggesting significant changes to the Medicare Shared Savings Program, aimed at accelerating the path for providers participating in a Medicare ACO to take on risk for the cost and care of their patient populations. The following is a summary of key changes proposed to the MSSP.

Read More
2019 Medicare Physician Fee Schedule Proposed Rule: How to Get Paid MORE for Remote Patient Monitoring Services

With the July 12, 2018 release of its proposed Medicare Physician Fee Schedule for 2019, CMS further opened the door for use and reimbursement of Remote Patient Monitoring (or Remote Physiologic Monitoring, "RPM") services. In doing so, CMS recognizes the role that new communications technologies play in increasing patient engagement and reducing unnecessary costs.

Read More
Top Changes to 2018 Medicare Physician Fee Schedule

The 2018 Medicare Physician Fee Schedule Final Rule (“2018 MPFS” or “Final Rule”) went into effect on January 1. Marked by new additions to the Telehealth codes and the un-bundling of Remote Patient Monitoring code CPT 99091, the 2018 MPFS provides plenty of opportunities for providers to grow their practice through digital medicine. This article outlines key changes to the new Rule. 

Read More
Top Changes to 2017 Medicare Physician Fee Schedule (MPFS)

Last week, Nixon Law Group attended the Virginia Medical Group Management Association (VMGMA)‘s fall meeting in Williamsburg, and we were lucky enough to sit in on a session by the dynamic and talented Elizabeth Woodcock (of Woodcock & Associates). It was a whirlwind session on the key changes in the 2017 MPFS Proposed Rule, and we wanted to pass along all of the juicy details.

Read More