CMS Finalizes Medicare Clinician Policy, Payment, and Quality Provisions for CY 2020

On November 1, CMS issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) effective on or after January 1, 2020. This includes three new telehealth codes to describe a bundled episode of care for treatment of opioid use disorders, Medicare coverage for opioid treatment programs, updates to care management services, implementation of a ground ambulance data collection system, and a revision to the current supervision requirement to clarify physician supervision requirements for physician assistants (PAs), among other updates. The rule also makes updates to Medicare’s Quality Payment Program including performance thresholds and category weights for the 2020 performance period and clarifying the definition of rural for the purposes of the Merit-Based Incentive Payment System (MIPS). As part of this rulemaking, CMS included an interim final rule with comment period (IFC) to establish coding and payment for evaluation and management, observation and the provision of self-administered Esketamine, with comments on that proposal due no later than 5 pm on December 31, 2019.  Click here for more information from the Federal Register.