CMS' 2023 Medicare fee schedule will affect chronic pain practices and some anesthesia and critical care providers, Tony Mira, CEO of Anesthesia Business Consultants, wrote in a Dec. 6 blog post.
Here are the big changes to note, according to Mr. Mira.
Evaluation and management:
CMS has revised its coding and documentation framework for CPT code definition changes including:
- New descriptor times
- Revised interpretive guidelines for medical decision-making levels
- Choice of medical decision-making or time to select code level
- Eliminated use of history and exam to determine code level, instead requiring a medically appropriate history and exam
CMS also finalized its proposal to maintain current billing policies for evaluation and management services.
Split or shared evaluation and management visits:
The final rule confirms the delay of the split visits policy, which determines that professionals should bill for a shared visit by defining the substantive portion of the service as more than half the total time.
The rule will instead remain the same as 2022, where the clinician can choose between history, physical exam, medical decision-making and time to determine the substantive portion.
The final rule extends the time that certain services are included under telehealth during the public health emergency for at least 151 days following the end of the public health emergency.
Chronic pain management service:
The final rule creates new HCPCS codes for chronic pain management services, including a bundle of services during a one-month period that CMS calls the starting point for "holistic chronic pain care."
Read more here.