Medicare Fee Schedule 2015

Medicare Announces 2015 Fee Schedule

"The proposed rule does not include proposals or announcements on the PFS [physician fee schedule] update or SGR [sustainable growth rate formula] as these calculations are determined under a prescribed statutory formula that cannot be changed by CMS," the agency noted in a press release.

CMS added that although the final figures will be announced in the final rule in November, "the Protecting Access to Medicare Act (PAMA) of 2014 provides for a zero percent PFS update for services furnished between Jan. 1, 2015 and March 31, 2015."

Highlights from the fee schedule include:

Proposing a payment rate of $41.92 for the chronic care management code, which can be billed only once per month per patient. "We also propose to allow greater flexibility in the supervision of clinical staff providing CCM services," the agency noted in a fact sheet.

·         Making changes to the global surgery code. CMS is "proposing to transform all 10- and 90-day global codes to 0-day global codes beginning in calendar year 2017," CMS said. "The Office of the Inspector General has identified a number of surgical procedures that include more visits in the global period than are being furnished." The agency plans to have one code for services provided on the day of surgery, and pay separately for postsurgical services.

·         Adding the following services to telehealth benefits: annual wellness visits, psychoanalysis, psychotherapy, and prolonged evaluation and management services.

·         Making changes to Open Payments, the new program to disclose ties between providers and pharmaceutical and device companies. Among other changes, CMS is proposing to remove an exclusion for reimbursement related to continuing medical education. "Eliminating the exemption for payments to speakers at certain accredited or certifying continuing medical education events will create a more consistent reporting requirement, and will also be more consistent for consumers who will ultimately have access to the reported data," the agency noted. CMS also wants manufacturers to report stocks, stock options, and other ownership interests as separate categories because "this will enable us to collect more specific data regarding the forms of payment made by applicable manufacturers."

 

 

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