Original Source: Center for Connected Health Policy
CY 2020 Final Physician Fee Schedule Released
The Center for Medicare and Medicaid Services (CMS) published their final CY 2020 Physicians Fee Schedule (PFS) in the first week of November. CMS has finalized the addition of three new codes for a bundled episode of care for treatment of opioid use disorder to the list of services that are eligible for telehealth reimbursement. CMS is allowing these services to be delivered at any telehealth originating site, including the patient’s home without regard for the geographic requirement, in accordance with the SUPPORT Act. Additionally, CMS has adopted a bundled payment structure for opioid use disorder (OUD) treatment by opioid treatment programs (OTPs), which would allow for the counseling and therapy components to be delivered via live interactive video. CMS has also taken steps to further refine its transitional care management (TCM) and chronic care management (CCM) codes, and create new codes for principal care management (PCM) services for patients that have only one serious chronic condition. They also issued a clarification for federally qualified health centers (FQHCs) and rural health clinics (RHCs) that remote physiologic monitoring codes are not reimbursable in FQHC or RHC settings because it is considered included in their RHC All-Inclusive Rate (AIR) or FQHC Prospective Payment System (PPS) sum. Finally, based on feedback CMS received that obtaining consent for each and every communication technology-based service is burdensome, they have revised this policy for CY 2020 to only require consent once a year for technology-based services.