The Centers for Medicare & Medicaid Services (CMS) has published the 2105 Medicare Physician Fee Schedule (MPFS), which updates payment policies and payment rates for services furnished to Medicare beneficiaries by physicians and other practitioners. The payment provisions of the final rule are effective January 1, 2015 through March 31, 2015 unless there is legislative intervention.
Provisions of the final rule include:
- Beginning in 2015, CMS will pay for chronic care management (CCM) services separately for Medicare beneficiaries who have two or more significant, chronic conditions. The final rule establishes a payment rate for CCM services that may be billed up to once per month for each qualified patient. CCM services include communication and coordination among a care team, medication management, and consistent review of a patient’s plan of care.
- A new process for determining fee schedule payment rates will be established that will allow for greater public input and transparency prior to payment rates being set. The final rule allows the payment rates to go through notice and comment rulemaking prior to being adopted.
- The telehealth benefit will be expanded to include the annual wellness visits, psychoanalysis, psychotherapy, and prolonged evaluation and management services.
In addition, the final rule establishes new requirements related to the 2017 Physician Quality Reporting System (PQRS) payment adjustment. Beginning in 2015, the program will apply a payment adjustment to professionals who do not report data on quality measures for particular professional services. CMS has also added the new measure that is defined as infection within 180 days of Cardiac Implantable Electronic Device (CIED) implantation, replacement or revision.