Additional Details
Reimbursement Updates
- CMS is finalizing a CY 2024 conversion factor of $32.74, which is 3.4% less than the CY 2023 conversion factor of $33.89. Similar to the conversation factor decrease experienced in 2023, 这一减少继续反映了法定增收到期和预算中性调整.
Coding and Coverage
- Caregiver Training Services: CMS正在最终确定其建议,即当从业人员(包括bet8网站备用), nonphysicians, 和治疗师)培训和参与护理人员,以支持患者对某些疾病和疾病的治疗计划, such as dementia.
- Services for Health-Related Social Needs: 更好地利用提供多学科支助所需的资源, CMS正在最终确定其单独支付社区卫生整合(CHI)费用的提案。, Social Determinants of Health (SDOH) Risk Assessment, and Principal Illness Navigation (PIN) Services.
- CMS还最终确定将SDOH风险评估添加到年度健康访问中,作为附加付款的可选元素,没有患者共同保险或免赔额. Further, CMS正在最终确定这些风险评估的拟议代码和付款,并将在E&M visit.
- Add-On Payment for E&M Services:Beginning January 1, 2024, CMS正在最终确定HCPCS代码G2211(延长办公室/门诊E)的单独附加支付的实施方案&(Mbet8娱乐),以更好地说明提供纵向和慢性疾病护理bet8娱乐的成本.
- Of note, 这一附加支付的实施对PFS下的其他2024年CY支付产生了再分配影响, due to statutory budget neutrality requirements.
- Split/Shared E&M Visits: For CY 2024, CMS正在对分离(或共享)访问的“实质性部分”定义进行最后修订,以包括对CPT指南的修订. Specifically, for Medicare billing purposes, 实质性部分反映了bet8网站备用或非bet8网站备用从业人员花费的总时间的一半以上, or a substantive part of the medical decision-making. Of note, CMS实施了公众意见,要求定义说明在就诊和/或医疗决策中花费的时间.
- Telehealth Service Flexibility: CMS正在最后确定几项建议,以便在如何提供远程医疗方面继续为从业人员提供灵活性, at least until the end of 2024. This includes finalizing the:
- 建议在2024年度临时将健康和福祉指导bet8娱乐添加到医疗保险覆盖的远程保健bet8娱乐清单中,并在永久基础上增加SDOH风险评估.
- 对在人们家中提供的远程保健bet8娱乐实行非设施PFS费率的建议.
- 延续直接监督的定义,允许在12月31日前通过实时音频和视频互动电信进行监督从业人员的存在, 2024.
- 到2024年年底,继续允许医师在住院医师培训地点提供远程医疗bet8娱乐时使用音频/视频实时通信技术.
- 执行《bet8网站备用》(CAA)规定的若干条款, 包括但不限于临时扩大原远程保健站点, expansion of the definition of telehealth practitioners, 继续为农村卫生诊所和联邦合格卫生中心提供的远程保健bet8娱乐付费.
- Behavioral Health Services:
- To implement provisions from the 2023 CAA, CMS正在最终确定其提案,提供MFTs和MHCs医疗保险B部分覆盖和支付在PFS下. CMS还将最终确定对行为健康整合代码的相应修改,以允许MFTs和mhc为bet8娱乐收费.
- Also included in the CAA, CMS正在最终确定其建议,为心理治疗危机bet8娱乐建立新的HCPCS代码,这些代码将在适用的bet8娱乐场所(任何适用非设施心理治疗危机bet8娱乐费率的bet8娱乐场所)提供, other than the office setting, including the home or a mobile unit). 这些危机bet8娱乐的费用将相当于每年非设施bet8娱乐地点费用表金额的150%.
- CMS也正在最终确定其允许健康行为评估和干预(HBAI)bet8娱乐的提案(CPT代码96156), 96158, 96159, 96164, 96165, 96167, and 96168) to be billed by clinical social workers, MFTs, MHCs, and clinical psychologists.
- CMS也正在最终确定修改临终关怀参与条件(cop)要求的提案,以允许社会工作者, MHCs, or MFTs to serve as members of the hospice’s interdisciplinary group (IDG).
- Finally, 医疗保健和医疗bet8娱乐委员会正在最后确定其建议,对根据计划方案支付的心理治疗代码的工作定额进行调整, which CMS will implement over a four-year transition period. In response to public comments, CMS也正在最终确定将这一调整应用于以E开头的心理治疗代码&M visit and to the HBAI codes.
- Opioid Treatment Programs (OTPs): CMS正在最终确定其提案,以延长目前的灵活性,允许在2024年年底之前通过纯音频电信提供评估.
Other Updates
- Medicare Part B Payment for Preventive Vaccine Administration: Effective January 1, 2024, CMS正在将家庭COVID-19疫苗接种的额外支付扩大到肺炎球菌, influenza, and hepatitis B vaccines administered in the home.
- Expanded Diabetes Screening: CMS正在完成其扩大糖尿病筛查覆盖范围的提案,以包括血红蛋白A1c (HbA1c)测试, to simplify and expand frequency limitations, 并从“糖尿病”筛查的编纂定义中删除特定的临床测试标准.
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Edited by: Matt Maslin
Published November 2, 2023