Part B News | Part B News

Prepare for debut of chronic pain management services, billing rules

11/21/2022

Take note of a new billing opportunity if your Medicare patients suffer from chronic pain. Medicare finalized a care management service for chronic pain management (CPM), and type of specialty isn’t a barrier to reporting it. The agency stressed that the CPM services can be reported by a wide range of providers, including primary care practitioners, according to the final 2023 Medicare physician fee schedule. The services take effect Jan. 1.

CMS adds 151 days to telehealth waivers – but that’s it

11/21/2022

by: Roy Edroso

In the 2023 Physician Fee Schedule final rule, CMS has pulled the last ace for providers who have come to rely on the hundreds of service codes that have been authorized for telehealth payment outside the usual telehealth rules since 2020: It has authorized a 151-day extension of those codes from the last day of the COVID-19 public health emergency (PHE).

CMS nixes G codes for RTM services, will allow general supervision

11/21/2022

by: Laura Evans, CPC

In an apparent about-face, CMS has decided not to adopt four HCPCS codes the agency had proposed to cover in place of remote therapeutic monitoring (RTM) treatment management services CPT codes 98980 and 98981. Instead, the agency established a new policy stating that “any RTM service may be furnished under our general supervision requirements,” according to the final 2023 physician fee schedule.

Medicare opens care management services to psychologists, social workers

11/21/2022

by: Roy Edroso

To complement the existing general behavioral health intervention (BHI) code 99484, CMS is authorizing service codes for use by clinical psychologists (CP) and clinical social workers (CSW).

Medicare opens care management services to psychologists, social workers

11/21/2022

by: Roy Edroso

To complement the existing general behavioral health intervention (BHI) code <strong>99484</strong>, CMS is authorizing service codes for use by clinical psychologists (CP) and clinical social workers (CSW).

Vaccine administration payments tied to economic, geographic factors

11/21/2022

by: Roy Edroso

CMS provided a minor lift to preventive vaccine payment, including for COVID-19, via new geographical and economic-factor adjustments, according to the final 2023 Medicare physician fee schedule released Nov. 1.

Age lowered for colon cancer screening, audiologists can order, and more

11/21/2022

by: Roy Edroso

Check out additional regulatory changes contained in the final 2023 Medicare physician fee schedule, from new colon cancer screening guidelines to dental services coverage and more.

Denials for prolonged codes hint at trouble for practices in the new year

11/21/2022

by: Julia Kyles, CPC

Practices will experience a spike in denials for prolonged services in 2023 if they aren’t prepared for the next round of coding updates. Medicare Part B claims data show that denials for prolonged services by physicians and qualified health care professionals (QHP) in the outpatient setting (99354 and 99355) increased from an average of 10% in 2020 to an average of 30% in 2021.

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