CMS pitches physician payment rule for 2021: 6 things to know

Here are six takeaways from the proposed rule:.

CMS released its yearly proposed modifications to the Doctor Cost Set Up for 2021, which would update the payment rates for doctor services and broaden the list of telehealth services covered by Medicare..

1. Payment upgrade. With the budget neutrality modification to represent modifications in relative worth systems, as required by law, the proposed Physician Fee Schedule conversion element for 2021 is $32.26, below $36.09 in 2020..

2. Telehealth. CMS proposed adding numerous services to the Medicare telehealth services list throughout the general public health emergency for the COVID-19 pandemic, including home check outs for established clients and neuropsychological and psychological testing. The department also proposed including the following services to the list of Medicare telehealth services on a Category 1 basis, meaning the services are comparable to those already on the list:.

Check out intricacy connected with certain office/outpatient examination and management.
Prolonged services.
Group psychotherapy.
Neurobehavioral status exam.
Care planning for clients with cognitive impairment.
Domiciliary, rest house or custodial care services.
House check outs.

Direct guidance by interactive telecommunication innovation. For the period of the public health emergency CMS adopted a policy revising the meaning of direct guidance to consist of virtual presence of the monitoring doctor or practitioner utilizing real-time video communications innovation.

4. Evaluation and management coding and payment. When prolonged workplace and outpatient assessment and management check outs can be reported, CMS proposed a refinement to clarify the times. The department proposed revaluing eight code sets, including maternity services, treatment examination and transitional care services..

Medicare Shared Savings Program. CMS proposed changes to the Medicare Shared Savings Program quality performance requirement and reporting requirements for the performance year beginning Jan. 1, 2021.

6. Comment period. Public discuss the proposed guideline are due by Oct. 5..

More articles on healthcare financing: 9 health systems with strong financesCMS terminates Missouri medical facilitys Medicare contractTenets net income more than triples in Q2.

CMS proposed including a number of services to the Medicare telehealth services list during the public health emergency for the COVID-19 pandemic, consisting of house visits for established patients and mental and neuropsychological testing. For the period of the public health emergency situation CMS embraced a policy modifying the definition of direct supervision to consist of virtual presence of the supervising doctor or professional utilizing real-time video interactions technology. CMS proposed a refinement to clarify the times when prolonged office and outpatient evaluation and management sees can be reported. Medicare Shared Savings Program. CMS proposed modifications to the Medicare Shared Savings Program quality efficiency standard and reporting requirements for the efficiency year starting Jan. 1, 2021.

© Copyright ASC COMMUNICATIONS 2020. Intrigued in LINKING to or REPRINTING this content? View our policies by clicking here.