The Centers for Medicare & Medicaid Services (CMS) has issued its 2024 Medicare Physician Fee Schedule (PFS) final rule. Coming in at nearly 3,000 pages, the rule finalizes many significant additions and changes in areas including remote services, care management services, and preventive services. Below we highlight some of the most notable developments.
Here are highlights from the PFS final rule.
1. Remote patient monitoring and remote therapeutic monitoring services for FQHCs and RHCs
CMS finalized its policy to reimburse remote patient monitoring (RPM) and remote therapeutic monitoring (RTM) services when furnished by Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs). The changes offer FQHCs and RHCs an exciting opportunity to provide more comprehensive remote care management services to patients, while generating meaningful revenue. Tashnek will cover the potential earnings and patient benefits in more detail during the webinar.
2. Clarification of RPM and RTM policies
CMS addressed common questions about and clarified several RPM and RTM policies, including those concerning RTM services furnished by physical and occupational therapists in private practices.
3. Definition of direct supervision
CMS indicated it will continue to define "direct supervision" to permit presence and immediate availability of the supervising practitioner through real-time audio and video interactive telecommunications through at least the end of 2024.
4. Community health integration and principal illness navigation
CMS finalized codes and payment methods for new covered care management services: community health integration (CHI) and principal illness navigation (PIN). CHI services are intended to address unmet social determinants of health (SDOH) needs affecting the diagnosis and treatment of a patient's medical issues, while PIN services are intended to help Medicare patients diagnosed with high-risk conditions identify and connect with clinical and support resources.
5. New preventive services
CMS finalized codes and payment methods for social determinants of health (SDOH) risk assessments and caregiver training services. Starting in 2024, the SDOH risk assessment can be administered with a Medicare annual wellness visit (AWV) for additional payment or furnished with an evaluation and management or a behavioral health visit.