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You can say goodbye to the elevated payment rates that have buoyed Part B professional fees for most of 2024. Should CMS' proposals in the latest physician fee schedule hold, providers and medical groups will see a nearly 3% reduction to the Medicare Part B conversion factor in 2025.
 
The agency also announced plans to launch a slate of advanced care management services, set a deadline for big changes in the Merit-based Incentive Payment System, teased 2025-effective codes, floated a revamp of surgical modifier rules, and signaled the end of many entrenched telehealth flexibilities, among other policy changes and revisions, according to the proposed 2025 Medicare physician fee schedule, and its 2,248 pages of Medicare policy, released today.
 
 
The contents of Medicare’s proposed physician fee schedule are typically a mystery until CMS publishes the rule on the Federal Register. But this year is different.
 
 
Effective Oct. 1, coders will now have a way to capture a post-acute encounter for sepsis aftercare with the new code Z51.A (Encounter for sepsis aftercare).
 
This code, which was one of the 252 codes proposed earlier this year, was finalized as part of the FY2025 ICD-10 final code update — released July 3 by CMS along with the guidelines.
 
 
One question has come up about social determinants of health (SDOH) assessments with the Medicare annual wellness visit: If the provider taking the assessment finds the patient has social issues that should be addressed – e.g. housing status, transportation to health care appointments – is the provider obliged to address them, or simply document them? An expert responds.
 
 
We asked an antitrust attorney how exceptions in the new FTC noncompete rule -- for exception, the one for "senior executives" -- might apply in real-world scenarios.
 

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