On November 1, 2022, the US Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2023 final rule for services reimbursed under the Medicare Physician Fee Schedule (MPFS) (the Final Rule). The Final Rule establishes changes to Medicare Part B professional payment policies and rates for the upcoming year. The Final Rule provides much-anticipated clarity regarding Medicare coverage and payment for remote therapeutic monitoring (RTM) services and continues to develop CMS’s payment policies following the 2022 introduction of the RTM codes.
CMS finalized certain changes to the existing CPT codes for RTM services but declined to finalize the proposed replacement of these CPT codes with four new, specific Healthcare Common Procedure Coding System (HCPCS) G-codes (G-codes) for RTM services. Most importantly, CMS has addressed the supervision standards for clinical staff, prerequisites for billing RTM codes, and the potential creation of a general device code for RTM. Finally, CMS has finalized its payment policy for the new RTM code for cognitive behavioral therapy.
Click here to read the full analysis of the Final Rule.
For more information contact: Caroline Reignley (McDermott Will & Emery – Partner), Deborah R. Godes, Rosalyn R. Broad (McDermott Will & Emery – Associate), Jayda Greco (McDermott Will & Emery – Associate)