CMS Releases Medicare Physician Fee Schedule Final Rule

CMS Releases Medicare Physician Fee Schedule Final Rule

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On November 1, 2019, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2020 Medicare Physician Fee Schedule (MPFS) final rule. The final rule includes updates to payment policies, payment rates, and quality program provisions for services effective on or after January 1, 2020.

Some of the provisions included in the final rule:

Medicare Telehealth Services – The following HCPCS codes are being added to the list of telehealth services: G2086, G2087, and G2088, which describe a bundled episode of care for treatment of opioid use disorders.

Evaluation & Management (E/M) Services – CMS is mirroring the E/M changes that were adopted by the American Medical Association (AMA) Current Procedural Terminology (CPT) Editorial Panel for office/outpatient E/M visits.

Physician Supervision Requirements for Physician Assistants (PAs) – The regulation has been updated on physician supervision of PAs to provide them with greater flexibility to practice more broadly in accordance with state law and state scope of practice.

Review and Verification of Medical Record Documentation – In order to reduce burden, CMS finalized broad modifications to the documentation policy so that physicians, physician assistants, and advanced practice registered nurses (APRNs – nurse practitioners, clinical nurse specialists, certified nurse-midwives, and certified registered nurse anesthetists) can review and verify (sign and date), rather than re-documenting, notes made in the medical record by other physicians, residents, medical, physician assistants, and APRN students, nurses, or other members of the medical team.

Medicare Coverage for Opioid Use Disorder Treatment Services Furnished by Opioid Treatment Programs – CMS is implementing a new Medicare Part B benefit for opioid use disorder (OUD) treatment services, including medications for medication-assisted treatment (MAT), furnished by opioid treatment programs (OTP).

Counseling and Therapy Services – Finalized a policy to allow counseling and therapy services described in the bundled payments, to be furnished via two-way interactive audio-video communication technology as clinically appropriate.

Beneficiary Copayment – There will be a zero beneficiary copayment for 2020.

The final rule will be published in the November 12, 2019 Federal Register.


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