CMS fee scheduleproductivityreimbursementtotal joint replacementswork relative value unitsIntroduction On December 20, 2020, the Centers for Medicare and Medicaid Services (CMS) finalized its proposed rule: CMS-1734-P. This 2021 Final Rule significantly changed Medicare total joint arthroplasty (TJA) ...
CMSissuedthe the calendar year 2025 Medicare physician fee schedule final rule with the goal of strengthening primary care and increasing access topreventive services. Under the physician fee schedule (PFS), average payment rates will reduce the conversion factor by 2.83% in 2025 comp...
CMS is finalizing the proposal without modification to continue 340B payments for acquired drugs and biologicals at the statutory default rate, which is the average sale price (ASP) plus 6%. CMS also issued aseparate final ruleon November 2, 2023, to discuss payment for 340B drugs for CY 20...
Among those policies is an expansion of telehealth services under the Physician Fee Schedule. If finalized, the rule would codify recently enacted legislation that removes some statutory restrictions on telehealth use for the diagnosis, evaluation, and treatment of mental health disord...
In its 2024 Medicare Physician Fee Schedule (MPFS)final rule, the Centers for Medicare & Medicaid Services (CMS) included asectiontitled “Clarifications for Remote Monitoring Services”, responding to comments received on the proposed rule relating to remote patient monitoring (RPM), remote therapeut...
(the JZ modifier) to attest that there were no discarded drug amounts. CMS proposed requiring the use of the JZ modifier in all instances in which there are no discarded amounts of single-dose and single-use package drugs. In the CY 2023 Medicare Physician Fee Schedule (MPFS...
Some radiation oncologists may breathe a little easier for now because the CMS has decided not to cap certain freestanding radiation oncology reimbursements in its Physician Fee Schedule Final Rule.
On July 13, 2021, the Centers for Medicare and Medicaid Services (CMS) released the proposed2022 Physician Fee Schedule(PFS). The PFS helps determine payment and reimbursement rates, clarifies evaluation and management policies, proposes policies for the 2022 performance year of the quality pa...
chedule methodology CMS proposes changes to physician fee schedule methodologyCMS proposes changes to physician fee schedule methodology
The proposed 2022 physician fee schedule, enacted through the Consolidated Appropriations Act of 2021, creates opportunities and some new challenges for telehealth. Sean Sullivan and Brian Lee discuss how these changes create new flexibilities but could also restrict Medicare benefici...