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.
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.
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).
On July 29, 2019, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that includes proposals to update payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January1, 2020. CMS is requesting comments on the proposed rule by September 27, 2019, and a final rule is expected to be released in November. The proposed rule estimates a conversion factor (CF) of $36.09 which is a slight increase from the 2019 CF of $36.04.
The World Health Organization (WHO) adopted the eleventh revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11) at its World Health Assembly meeting in May 2019. It addition to other major changes, ICD-11 includes a new classification for chronic pain as well as new groups of codes for chronic pain conditions. After a decade of preparation, ICD-11 will become effective in January 2022. The advance release allows countries to plan how to use the new version and train health professionals.
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.