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domain was triggered too early. This is usually an indicator for some code in the plugin or theme running too early. Translations should be loaded at the init
action or later. Please see Debugging in WordPress for more information. (This message was added in version 6.7.0.) in /home3/thechcal/public_html/wp-includes/functions.php on line 6114The Centers for Medicare and Medicaid Services (CMS) recently released its Proposed Rule for the Calendar Year (CY) 2024 Medicare Physician Payment Schedule and Quality Payment Program (QPP). If finalized, these policies will take effect on January 1, 2024. The Proposed Rule Summary not only offers a glimpse into impending changes but also invites feedback from interested parties. The comment period lasts 60 days, concluding on September 11, 2023.<\/p>\n
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While numerous summaries and articles on the Proposed Rule exist, including the American Medical Association\u2019s (AMA) Summary, we\u2019ve highlighted significant policies with implications for FQHCs and RHCs.<\/p>\n
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Remote Physiologic Monitoring (RPM) and Remote Therapeutic Monitoring (RTM)<\/strong><\/p>\n \u00a0<\/strong><\/p>\n <\/p>\n Telehealth Services<\/strong><\/p>\n <\/p>\n In 2024, FQHCs and RHCs will continue receiving reimbursement for telehealth services based on PHE (public health emergency) standards, and there are several positive changes:<\/p>\n <\/p>\n Health-Related Social Needs:\u00a0PIN, CHI, and SDOH<\/strong><\/p>\n CMS is extending reimbursement for health-related social needs like Community Health Integration Services (CHI), Social Determinants of Health (SDOH) Risk Assessment, and Principal Illness Navigation Services (PIN) as part of the move toward value-based care. When community health workers, care navigators, and peer support specialists are involved in medically essential care, all three (CHI, PIN, and SDOH) will be separately reimbursable.<\/p>\n <\/p>\n E\/M visits<\/strong><\/p>\n HCPCS code G2211 has been approved as a separate add-on payment for outpatient office visits, reimbursing providers for treating a patient\u2019s single, serious, or complex chronic condition. However, it won\u2019t be paid if billed with an E\/M visit with a -25 Modifier.<\/p>\n <\/p>\n Behavioral Health and Health Behavior Assessment & Intervention (HBAI)<\/strong><\/p>\n Improvements to behavioral and mental health services for FQHCs and RHCs include:<\/p>\n <\/p>\n Diabetic Self-Management Training (DSMT) and Diabetes Screening <\/strong><\/p>\n CMS proposes promising modifications for diabetes screening and DSMT, such as:<\/p>\n <\/p>\n Dental and Oral Health<\/strong><\/p>\n CMS is also introducing coverage for some dental and oral health services that are integrally related to eligible medical services (for example, organ transplants, cardiac valve replacements, and valvuloplasty procedures), specifically:<\/p>\n <\/p>\n This overview highlights only some of the proposed changes for 2024. CMS is also expanding reimbursement for in-home administration of COVID vaccinations to include three more vaccines: pneumococcal, influenza, and Hepatitis B. Clinical diagnostic lab tests (CDLTs) will have modifications to data collection and reporting periods, as well as a restriction on payment reductions (payments for the current year cannot be reduced when compared to the prior year). CMS will allow some providers that qualify but have missing documents a discretionary 60-day stay of enrollment status when enrolling with Medicare and Medicaid. (Providers will not be paid for services or items provided to Medicare patients during the stay, but it does allow them to submit missing paperwork and avoid having to re-start the enrollment process.) Criteria and policies for Medicare Shared Savings Program (MSSP) Accountable Care Organizations (ACOs) will also be refined.<\/p>\n <\/p>\n While many changes are favorable, there are many additional changes that concerned providers should be aware of. We recommend reviewing both the AMA (American Medical Association) Summary (here<\/strong><\/a>) and the CMS proposed rule (here<\/strong><\/a>) for comprehensive insights. The AMA is particularly concerned about proposed changes to the Merit-based Incentive Payment System (MIPS) and has written to Congress (here<\/strong><\/a>), pushing for statutory reforms to improve and address fundamental issues with the program.<\/p>\n <\/p>\n Don\u2019t forget: CMS seeks comments on the proposed rules with a deadline of September 11, 2023. Make your voice heard!<\/p>\n <\/p>\n CMS instructions for commenting:<\/strong><\/p>\n <\/p>\n When commenting, please refer to file code CMS\u20131784\u2013P.<\/p>\n Comments, including mass comment submissions, must be submitted in one of the following three ways (please choose only one of the ways listed):<\/p>\n\n
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