The Centers for Medicare and Medicaid Services (CMS) has released the 2024 Medicare Physician Fee Schedule Final Rule, which is a complete listing of fees used by Medicare to pay doctors or other providers. CMS has finalized the payment policy for dental services for head and neck cancer treatments. CMS also codified allowing Medicare Part A and B payment for dental or oral examination performed as part of a comprehensive workup prior to medically necessary diagnostic and treatment services, to eliminate an oral or dental infection prior to, or contemporaneously with, those treatment services, and to address dental or oral implications after radiation. Finally, CMS has finalized its proposal to permit payment for certain dental services linked to other covered services used to treat cancer. The fee schedule is effective on or after January 1st, 2024.

Click here to view the final fee schedule.

The Office for Civil Rights (OCR) released two resource documents for providers and for patients to help explain to patients about privacy and security risks to their protected health information (PHI) when using telehealth services and ways to reduce these risks.

On Nov. 2, 2023, the Centers for Medicare and Medicaid Services (CMS) issued a final rule announcing finalized policy changes for Medicare payments under the Physician Fee Schedule (PFS), and other Medicare Part B issues, effective on or after Jan. 1, 2024. CMS is finalizing conforming regulatory text changes to implement:

• Extending payment for telehealth services furnished in FQHCs/RHCs through Dec. 31, 2024.
• Delaying the in-person requirements under Medicare for mental health visits furnished by FQHCs/RHCs.
• Including marriage and family therapists (MFTs) and mental health counselors (MHCs) as eligible for payment.
• Aligning enrollment policies so that addiction, drug, or alcohol counselors who meet all of the requirements of MHCs to enroll with Medicare as MHCs will also apply for FQHCs/RHCs.
• Medicare coverage and payment for intensive outpatient program (IOP) services furnished by an FQHC/RHC.
• Extension of the definition of direct supervision to permit virtual presence in FQHCs/RHCs through Dec. 31, 2024.
• A change to the required level of supervision for behavioral health services furnished “incident to” a physician or NPP’s services in FQHCs/RHCs to allow general supervision, rather than direct supervision, consistent with the policies finalized under the PFS during last year’s rulemaking for other settings.
• Inclusion of Remote Physiologic Monitoring and Remote Therapeutic Monitoring in the general care management HCPCS code G0511 when these services are furnished by FQHCs/RHCs.
• Inclusion of Community Health Integration (CHI) and Principal Illness Navigation (PIN) services in the general care management HCPCS code G0511 when these services are provided by FQHCs/RHCs. RHCs and FQHCs that furnish CHI and PIN services will be able to bill these services using HCPCS code G0511, either alone or with other payable services on an RHC or FQHC claim, for dates of service on or after Jan. 1, 2024.
• A change in the methodology to calculate the payment rate for the general care management HCPCS code G0511 that takes into account how frequently the various services are utilized.
• A clarification that obtaining beneficiary consent for chronic care management and virtual communications services is required, but the mode of obtaining the consent can vary and direct supervision is not needed.

Review the CMS press release on the PFS, a summary table, Expanded Medicare Reimbursement for FQHCs Starting Jan. 1, 2024, and a one-pager on the new Intensive Outpatient Program benefit.

The Centers for Medicare and Medicaid Services (CMS) was set to implement a deadline requiring Medicare enrollment of home addresses for providers performing telehealth from home. The date for completion of this work was December 31, 2023, but CMS in a November 6 document, Physicians and Other Clinicians: CMS Flexibilities to Fight COVID-19, extended the deadline through December 31, 2024, in response to concerns raised by providers, PACHC, NACHC, and others. Earlier, CMS shared that although this information will be collected for CMS records, the home address does NOT go out on the claims. Between now and the deadline, CMS will work on processes to protect home addresses from public disclosure.

The annual Low-Income Home Energy Assistance Program (LIHEAP) application process for the 2023-24 season is now open for consumers. LIHEAP is a federally-funded program administered by the Pennsylvania Department of Human Services that helps with home heating bills to aid families in staying warm and safe during the winter months. Assistance is available for renters and homeowners. The LIHEAP application period for both cash and crisis grants is open from Nov. 1, 2023, to April 5, 2024. Benefits are determined by county, income, household size and fuel type.

Thanks again to all those who attended the National Stakeholder Call with the CMS Administrator on October 17. In case you missed it, here’s the link to the call summary, recording and transcript: CMS National Stakeholder Calls.

The call featured CMS Administrator Chiquita Brooks-LaSure and her leadership team, who provided updates on CMS’ recent accomplishments and how our cross-cutting initiatives are advancing CMS’ Strategic Plan. CMS serves the public as a trusted partner and steward dedicated to advancing health equity, expanding coverage, and improving health outcomes as we engage the communities we serve throughout the policymaking and implementation process.

We hope you can join us for the next National Stakeholder Call early next year.