Expert Insights on the CMS Medicare Coding Updates

Each year CMS/Medicare proposes policy changes for Medicare Payments under the Physician Fee Schedule(PFS) that are finalized by early December. Items such as the conversion factor are a part of this much-anticipated document along with other changes that affect payment to providers from Medicare in a variety of situations.

The Final Rule for the PFS was released and addressed a significant number of items. Many of the waiver items that we are currently working under are continued through the end of the calendar year in which the Public Health Emergency (PHE) ends or December 31, 2021. Details of each and any exclusions or omissions will be discussed including a new Category of Telehealth codes.

For 2021, there are significant changes to Office & Other Outpatient Services with the re-defining of 99201-99215 by the AMA. CMS/Medicare has released code numbers and additional information regarding their position on these codes including Prolonged Service codes.

Webinar Objectives

The continuation of or lack thereof regarding waivers and specific services that are currently in use during the Public Health Emergency (PHE) is important information for offices. Planning for 1-1-21 and what options both a primary care office and a specialty office would have regarding their patients requires information that is contained in the Medicare PFS Final Rule for 2021. The  objective of the webinar is to identify which of these services and waivers are available for providers in the new year and also after the end of the Public Health Emergency. Understanding CMS/Medicare’s position on some new codes that have been released by the AMA in CPT is as important to providers in looking ahead to what their practice model is in 2021.

Webinar Highlights

• Telehealth Visits
  • Which codes are being permanently added to the list of Category 1 services
  • What is Category 3 telehealth codes
  • Which codes are being added to this new category
• Skilled nursing facilities frequency limitation changes for 2021
• Services by PT, OT, SLP and some mental health professionals have new codes to work with in their remote revaluation of patients
• Medicare ‘s position on Audio only calls outside the PHE
• Clarifications to Remote Physiologic Monitoring Services
• Continuation of waiver allowing certain Other Qualified Health Care Professionals to supervise diagnostic tests
• Clarifications to the Visit Complexity code
• Comments on modifications to the documentation requirements of physicians

Who Should Attend

Coders, Billers, Office Managers, Practice Managers, NP’s and PA’s