CMS has released the 2025 Proposed Medicare Physician Fee Schedule. The proposal contains many significant coding and coverage provisions including:
- 2.93% payment decrease
- Permanent coverage of audio only encounters under telehealth when all other criteria are met
- Extension of the waiver of frequency limitations on subsequent hospital, nursing facility, and critical care consults performed using telehealth
- Permanent allowance to allow the immediately available requirement for direct supervision to be rendered via telehealth for certain incident to and diagnostic testing services
- Addition of a visit complexity add-on code for infectious disease services provided in a hospital inpatient or observation setting
- Expanded payment and coverage for caregiver training services
- Addition of new advanced primary care management service codes
- Addition of a post-operative visit complexity code
- Addition of a new ASCVD risk management code
- Expanded payment, coverage, and the addition of new codes for mental health services, including safety planning interventions for patients in crisis
- Changes to the signature requirements for therapy treatment plans
- Expanded coverage of preventive medicine screening services
- NO proposals related to split/shared services
The documentation and coding requirements related to the proposed new services are extensive and complicated. We recommend reviewing the proposed rule in its entirety to identify the issues pertinent to your organization and begin developing an implementation plan.
The Proposed Rule can be found here:
https://www.federalregister.gov/public-inspection/2024-14828/medicare-and-medicaid-programs-calendar-year-2025-payment-policies-under-the-physician-fee-schedule
The CMS fact sheet can be accessed here:
https://www.cms.gov/newsroom/fact-sheets/calendar-year-cy-2025-medicare-physician-fee-schedule-proposed-rule |
