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10 key RPM updates: CMS clarifies who can bill, permits acute diagnoses, confirms PHE tie-in
12/21/2020
by: Julia Kyles, CPC
The final 2021 Medicare physician fee schedule contains more clarity for practices that report remote patient monitoring (RPM) services and a warning that only two of the changes spurred by the COVID-19 pandemic will be permanent.
With scope of practice changes, CMS loosens authority for many providers
12/21/2020
by: Roy Edroso
CMS has been eyeing changes to the federal scope of practice regulations for the group of professionals they refer to as non-physician practitioners (NPP) for years, and the agency specifically solicited comments in its “Feedback on Scope of Practice” directive as part of its Patients over Paperwork initiative. The final 2021 Medicare physician fee schedule sets the stage for 2021 changes.
Opioid treatment expands, with Narcan payable, requirements in AWV, IPPE
12/21/2020
by: Roy Edroso
CMS pushed its opioid treatment model a little further forward by finalizing some small but meaningful changes in the physician fee schedule final rule — though one expert says a “paradigm shift” is needed to more effectively reach the millions of Americans with substance abuse problems.
In review: Remote physiologic monitoring codes, descriptors and staff requirements
12/21/2020
by: Julia Kyles, CPC
CMS provided more guidance for coding and billing remote physiologic monitoring (see story, p. 1). The chart above provides codes, descriptors and the staff who may perform each service. Note that the services must be ordered and billed by a provider who can bill for E/M services.
2021 outlook: CMS takes aim at misvalued codes, retires group of NCDs
12/21/2020
by: Laura Evans, CPC
CMS finalized its proposal to consider revaluing one code over the next year: 22867 (Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance, when performed, with open decompression, lumbar; single level), which was nominated as undervalued in order to add the work of decompression.
More 2021 PFS updates: Care management code changes, COVID billing rules and more
12/21/2020
by: DecisionHealth Staff
From the adoption of a CPT code for chronic care management (CCM) services to a range of other billing and quality reporting updates, below you’ll find additional updates from the final 2021 Medicare physician fee schedule, which takes effect Jan. 1.
CMS selected-procedure chart highlights the 2021 CF blow to reimbursement
12/21/2020
by: Roy Edroso
Among the documents related to the final 2021 Medicare physician fee schedule that should interest practices is the “Impact on CY 2021 payment for selected procedures” chart, showing the estimated impact of reimbursement changes on procedures chosen by CMS “from among the procedures most commonly furnished by a broad spectrum of specialties.”

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