The Centers for Medicare & Medicaid Services (CMS) has issued its 2025 physician fee schedule (PFS) final rule. It includes many revisions and additions that significantly affect the billing, coding, and delivery of remote care management.
We'll be taking a deep dive into these and the other remote care management changes and additions you should know about in a detailed webinar on November 19 at 2:00 PM ET / 11:00 AM PT. Register here. If you can't make the webinar, we encourage you to still sign up as all registrants will receive a recording of the program.
5 Noteworthy Changes Included
While we're still assessing the 3,000-plus page final rule, a number of changes already stand out. Here are five topics we'll be covering more extensively in our webinar.
1. Major overhaul of the recent RPM and CCM expansion for FQHCs
CMS is splitting HCPCS code G0511 — used by federally qualified health centers (FQHCs) and rural health clinics (RHCs) — into distinct payments based on the care management service rendered. G0511 has been used as a catch-all code for numerous services, including remote patient monitoring (RPM) and chronic care management (CCM). The 2024 PFS final rule included RPM and remote therapeutic monitoring (RTM) in HCPCS G0511. This overhaul significantly expands the flexibility and number of reimbursable services for FQHCs and RHCs with care management and remote monitoring programs.
2. Overhaul of care management for primary care offices
CMS is creating new codes and payments for Advanced Primary Care Management services (APCM). Three new HCPCS G-codes bundle elements of several existing care management and communication technology-based services. The bundles reflect the essential elements of the delivery of advanced primary care, including CCM, principal care management, and transitional care management. These codes can be used by primary care providers as well as FQHCs and RHCs.
3. Audio-only telehealth waiver expansion
CMS is permitting the use of audio-only communication — instead of requiring video — to satisfy the interactive communication requirement for telehealth visits.
4. Big news for virtual direct supervision
CMS is permanently allowing virtual direct supervision for some services with established patients and extended virtual direct supervision for all services through the end of 2025.
5. Introduction of caregiver training services (CTS) codes
CMS is establishing new coding and reimbursement for caregiver training for direct care services and supports. Topics of trainings can include infection control, medication administration, wound dressing changes, special diet preparation, and medication administration. CMS is also establishing new coding and reimbursement for caregiver behavior management and modification training that could be furnished to the caregiver(s) of an individual patient. These CTS services can be provided via telehealth.
2025 PFS Final Rule Webinar: Join Us November 19
If your organization provides or is considering delivering remote care management or annual wellness visits with preventive services, CMS is proceeding with a lot of big changes that you will want to know about. Get more information on the changes noted above, AMA's expansion of RPM codes, ramifications of the Office of Inspector General RPM report, and the steps you should consider taking in our webinar, "Understanding Medicare's 2025 Changes to Remote Care Management," on November 19 at 2:00 PM ET / 11 AM PT. Sign up for this can't-miss program today!