Recently the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that announces the proposed policy changes for Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues, effective on or after January 1, 2025. Join us for an insightful webinar to understand the CMS. Medicare’s 2025 changes to remote care billing, coding, and reimbursement. The Centers for Medicare & Medicaid Services (CMS) has unveiled the proposed rule for the 2025 Medicare Physician Fee Schedule (MPFS), which includes significant changes that could impact the delivery, coding, and billing of remote care management. These changes also introduce new services that providers can incorporate to help mitigate the overall payment reduction.

Expert Dr. Irina Koyfman, DNP, NP-C, RN, will review the CMS Medicare’s changes in remote patient monitoring, remote therapeutic monitoring, care management, Federally Qualified Health Centers (FQHCs), preventive care, behavioral health services, and telehealth and also guide you on how to be proactively compliant with these changes. These changes in physician payment policies can impact your practice’s reimbursement and payment systems.

Learning Objectives:

• Understand the information on 2025 Medicare’s new rules and regulations
• Ensure the accuracy and completeness of the information
• Improving Care Quality by emphasizing on value-based care and incentives for meeting quality metrics
• Enhancing Patient Outcomes by focusing on preventive care, early intervention and better management of chronic conditions
• Reducing overall costs by streamlining care to reduce unnecessary services and incentives for cost-effective care
• Know the proposed Medicare Telehealth Services List
• Learn the Recent Updates on Remote Patient Monitoring (RPM) and its implications
• Understand how to integrate the chronic care management and other care management services into Advanced Primary Care Model
• Know the CMS Behavioral Health Strategy and expanded coverage for digital therapeutics based on behavioral health software
• Learn the differences in coverage and reductions in remote therapeutic monitoring compared to RPM

Areas Covered in the Session:

• CMS Rule Making Timeline
  • July – Proposed Rule
  • September – All comments are due to CMS
  • End of November- CMS final review of the comments and finalize rule
• Program with no changes (for FFS)
• Proposed Changes for CY 2025
• The Conversion Factor
• Reduction in Reimbursement
  • 2024 (current) conversion factor – $33.29
  • 2025 proposed conversion factor – $32.36
• Caregiver Training Services (CTS)
  • 97550 – Caregiver training (ADLs, IADLs) (without the patient present), face-to-face; initial 30 minutes – $52
  • 97551 – face-to-face; each additional 15 minutes – $25
  • 97552 – Group caregiver training, face-to-face – $22
• Maintaining Telehealth Flexibilities
• Telehealth Flexibilities for Substance Use Disorder Treatment (“SUD”)
• General Supervision for All PT/OT Therapy Services
• NEW codes and program
• Case Management Coding Changes for FQHCs/RHCs
• Advanced Primary Care Management (APCM)
• Goals of the CMS Proposed Program
• APCM 13 Service Elements
• Billing for APCM
  • GPCM1 – APCM for patients with one or no chronic conditions – $10 PPPM
  • GPCM2 – APCM for patients with two or more chronic conditions – $50 PPPM
  • GPCM3 – APCM for patients with two or more chronic conditions and who are Qualified Medicare Beneficiaries (QMB) - $110 PPPM
• Digital Mental Health Treatment (DMHT)—3 new HCPCS codes for reimbursement
  • GMBT1
  • GMBT2
  • GMBT3
• Live Q&A Session

Attendees:

• Healthcare Administrators
• Physicians
• Nurses
• Nurse Practitioner
• Physician Assistants
• Medical Officers
• Medical Billers
• Medical Coders
• Population Health Officers
• Innovation Officers
• CNO/CMO
• PCP (MD, NP, PA)
• Specialists (MD, NP, PA)
• Nurse Managers
• C-Suite Healthcare Executives