CMS Proposes Including Telehealth in Physician Fee Schedule

(HealthDay News) — Earlier this month, the Centers for Medicare & Medicaid Services issued proposed rules for updates to the Physician Fee Schedule and will accept comments until Sept. 2, according to an article published in Medical Economics.

According to Medical Economics, while the proposed rule does not address any updates tied to the statutorily prescribed sustainable growth rate formula, it does contain updates related to chronic care management (CCM). 

These updates include a telehealth benefit and changes to the disclosure provisions in the Physician Payment Sunshine Act, namely requiring disclosure of payments drug and medical device manufacturers make to speakers at certain continuing medical education events.

Under CCM there is a proposed code with a payment rate of $41.92 (billable only once monthly per qualified Medicare beneficiary) for management of beneficiaries with two or more significant chronic conditions.

Management of these patients includes regular development and revision of a plan of care, communication with other treating health professionals and medication management. The proposal also allows greater flexibility in supervising clinical staff providing CCM. Additionally, proposed covered telehealth services include annual wellness visits, prolonged evaluation and management services, psychoanalysis and psychotherapy.

“This code recognizes the value of additional cognitive and administrative work that occurs outside the exam room but that is essential to comprehensive, coordinated care,” said Reid Blackwelder, MD, president of the American Academy of Family Physicians, according to the article.