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CMS reverses course and creates frequency limits for prolonged service codes G0316-G0318.
 
CMS has not released a final national coverage determination (NCD) for pre-exposure prophylaxis (PrEP) to prevent human immunodeficiency virus (HIV). And CMS did not discuss the service in the physician fee schedule final rule. But practices and clinics can find previews of the service in the 2024 HCPCS update, the relative value units (RVU) file for the 2024 Medicare and appendix B of proposed decision memo CAG-00464N.
 
The conversion factor cuts that CMS floated earlier in the year are now confirmed – and heightened. Part B providers will have to prepare for a net 3.4% payment decrease across services in 2024, according to the final 2024 Medicare physician fee schedule released today.
 
Also, you will find new services moving to active status, such as caregiver training and principal illness navigation, a one-year telehealth parity patch, key value-based care updates and the launch of the much anticipated add-on complexity code G2211.
 
 
Make sure you're staying accurate with an overhaul to the COVID-19 vaccine and administration codes. The AMA announced it is deleting a significant number of codes, replacing them with new codes and striking Appendix Q from the CPT Manual.
 
Medicare decides it will accept place of service 27 (Outreach site/street) “to align with broader CMS efforts to address economic, social, and other obstacles impacting Medicare beneficiary healthcare access.”

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