2020 Coding & CMS Policy Changes Webinar

AAPM coding and billing expert Emily Hill, PA will present a live webinar on December 11, 2-3 pm CT, designed to preview coding changes going into effect on January 1 related to pain medicine services. Learn more and reg...
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CMS Issues Final Rule for Physician Fee Schedule for 2020

The Centers for Medicare & Medicaid Services (CMS) issued its Final Rule for 2020 that that includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS). As proposed, the 2020 PFS conversion factor is $36.09 which is $0.05 above the 2019 conversion factor. The conversion factor is multiplied by the total adjusted Relative Value Units (RVUs) to achieve a payment amount for the services included in the Medicare Physician Fee Schedule.

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Medicare Contractor Proposes Changes to Coverage Policy for Percutaneous Vertebral Augmentation (PVA)

  The Medicare Administrative Contractor, National Government Services, Inc.(NGS), released a future Local Coverage Determination for PVA Osteoporotic Vertebral Compression Fractures effective December 1, 2019. The ...
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Understanding the CMS Proposal for Opioid Treatment Services

AAPM members have asked about the impact on their practices of the CMS proposal for opioid treatment services. Starting January 1, 2020 the Centers for Medicare & Medicaid Services (CMS) plans to pay Opioid Treatment Programs (OTPs) for opioid use disorder (OUD) treatment services, including medication-assisted treatment (MAT) medications, toxicology testing, and counseling, when given to people with Medicare Part B.

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Opportunity for Input to CMS Action Plan on Pain Management and SUD ends October 11

CMS has issued a Request for Information (RFI) required by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) asking for public comment on way...
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Understanding CPT, RUC and the 2020 Proposed Rule

The Proposed Rule for the 2020 Physician Fee Schedule proposes values for intrathecal/epidural pump procedures (CPT codes 62367-62370), the new codes for injection and ablation of genicular nerves (temporary CPT 64XX0 and 64XX1) and sacroiliac joint (temporary CPT 6XX00 and 6XX01), and somatic nerve injections (CPT codes 64405, 64418, 64420, 64421, 64425, 64430, and 64450).

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CMS Proposes Payment for Acupuncture

CMS has announced a proposal to cover acupuncture for certain Medicare patients with chronic low back pain (CLBP). To be covered, patients must be enrolled participants either in clinical trials sponsored by the National...
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Medicare Launches Initiative for Documentation Look-Up Tool

Medicare recently announced a plan to streamline the process of finding coverage and documentation requirements for applicable services. Currently, documentation requirements appear in various locations and on separate websites requiring physicians and staff to navigate multiple websites for information.

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New Part D Opioid Overutilization Policies

CMS implemented new opioid policies for Medicare drug plans effective January 1, 2019. Medicare Part D enrollees who have not filled an opioid prescription recently (within the last 60 days) will be limited to up to a 7-...
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