In its proposal 2022 Medical Insurance Physician Fees Schedule The Center for Medicare and Medicaid Services, released on Tuesday, has included plans to expand telemedicine access to behavioral health care.
The agency proposes to implement recently enacted legislation that allows patients to access telemedicine services in any geographic location and at home to treat mental health disorders.
With this change, CMS proposed for the first time that Medicare should be allowed to pay for mental health virtual consultations provided by rural health clinics and federally qualified health centers.
However, CMS includes a requirement that practitioners providing behavioral telemedicine services must conduct in-person visits within six months before the first virtual visit, and at least once every six months thereafter.
In addition, the agency hopes to allow pure audio communication technology to be used for the diagnosis, evaluation, or treatment of certain mental health disorders, rather than requiring both audio and video equipment. This includes counseling and treatment services provided through opioid treatment programs.
CMS administrator Chiquita Brooks-LaSure said: “The changes we propose will increase the availability of similar options for telemedicine and behavioral medicine to people in need, especially in traditionally underserved communities.” In the press release.
Another major change proposed in the payment rules focuses on remote patient monitoring.
Jake Harper, a partner at Morgan Law Firm, said that CMS is considering the introduction of new remote treatment management services, which are built on the existing remote patient monitoring code, but there are some important policy differences, including data collection methods and data The nature of Lewis, in an email.
“Depending on how the policies of these codes are consolidated, this may drastically change the emerging RPM/RTM industry,” he said.
In addition to the proposed changes in the coverage of telemedicine and remote patient monitoring services, CMS also aims to advance its value-based quality payment program. The agency hopes to require clinicians to reach a higher performance threshold to be eligible for awards.
The agency also proposed the first seven MIPS value pathways, which are a subset of measures and activities used to meet the reporting requirements of performance-based incentive payment systems. The clinical areas covered by these approaches include rheumatology, stroke care and prevention, heart disease, chronic disease management, lower extremity joint repair, emergency medicine, and anesthesia.
In addition, in a more controversial initiative, CMS plans to reduce the doctor’s fee schedule conversion factor per unit of relative value from US$34.89 to US$33.58. Medical insurance pays the doctor based on the conversion factor.
Anders Gilberg, the association’s senior vice president for government affairs, said in an email statement that the Medical Group Management Association “was concerned about the potential impact of the proposal to reduce the conversion factor by 3.75%.”
He said the organization plans to “seek Congressional intervention to avoid cuts.”
The entire 1,747 page of the proposed rule could be View here.
Photo: Sylverarts, Getty Images
