CMS Physician Final Rules for 2024 : Find out What CMS has Finalized from the Proposed Rules

Description

Every summer CMS publishes its proposed new physician payment and coding change guidelines for the coming year. November 1, 2023, CMS will publish its final rule confirming or changing issues from the proposed rules. In some circumstances, provider comments can influence CMS to deviate from their original proposed guidelines. It is very important for providers and staff to know what items in the proposed rule will move forward to 2023 and to know what CMS has decided not to move forward on in 2024. The proposed rule issues that were not implemented for 2023 may identify issues still being considered for 2024. This year there are significant changes to EM services, splits/shared care, remote patient monitoring (RPM) complex chronic care management (CCM), etc. that will require a complete change in the way services are coded outside of the office setting.

Speaker

Jan Rasmussen, PCS, ACS-OB, ACS-GI, – As a health care consultant Jan has more than 45 years of experience in physician billing, reimbursement, and compliance. Jan is currently the owner of Professional Coding Solutions, a healthcare consulting firm. She has been a Certified Professional Coder (CPC) since 1992. As a member of the American Academy of Professional Coders (AAPC) Jan previously served on their Advisory Board as the liaison to the AMA, has been a speaker for the AAPC annual conference as well as contributed to the development of the original AAPC’s independent study, university education programs, and proficiency tests. In 1994, she was honored by AAPC as Networker of the Year. Jan was also a Regional Governor for the American College of Medical Coding Specialists (ACMCS) serving as Chair of the Ethics committee and a member of the Examination committee.

In her role as a physician consultant, she has participated in physician coding and documentation reviews including OIG government PATH and Campus audits, and designed and conducted physician coding seminars nationwide. She has been a guest speaker for several conferences sponsored by United Communications, Inc//Decision Health, AAPC as well as Coding Institute Specialty Conferences.

In previous consulting positions, she was responsible for developing and conducting seminars for basic, intermediate, and advanced ICD-9-CM and CPT, teaching physician guidelines as well as special seminars for OB/GYN, Orthopedics, Urology, Gastroenterology, General Surgery, ENT, Cardiology, Emergency Medicine and Evaluation and Management. In her role as an educator, she has been teaching E/M documentation and auditing to both physician and coding audiences since 1992 when RBRVS was first implemented.

Jan has also worked for several major health insurance payers in Wisconsin, was a coding advisor to the WPS Medicare Carrier Advisory Committee, and served as the coding and reimbursement coordinator for a 37-provider, staff model HMO clinic. As the coding and reimbursement coordinator, Jan was responsible for physician office, hospital, surgical, and nursing facility coding charge ticket development, fee development, reimbursement analysis, claims analysis, and physician education.

Learning Objectives

Correct coding of EM services outside of the office setting
New Medicare Clinical Quality Measure (CQM) collection type for ACOs under the Alternative Payment Model (APM) Performance Pathway (APP)
CMS’s new conversion factor for 2024 affects your bottom line
Changes to colorectal cancer screening guidelines
How shared care will change or not change for 2024
Identify new telehealth services available after the end of PHE
Consider how the role of clinical psychologists, clinical social workers, professional licensed counselors, and licensed marriage and family therapists will improve access to behavioral health services
New codes and strategies for chronic pain management
Understand new payment methodology and codes for Methadone treatment drugs
Review finalized guidelines for patient access to audiology services and dental oral health care
Understand new payment and classification of wound care management products

Areas Covered

New conversion factor for 2024
New Medicare Clinical Quality Measure (CQM) collection type for ACOs under the Alternative Payment Model (APM) Performance Pathway (APP)
New EM codes and code categories outside of the office setting
New times associated with EM codes
New prolonged service G codes for Medicare patients
Split/Shared care
Colorectal screening guidelines
Updated telehealth availability
Chronic care management (CCM)
Availability for patient treatment by clinical psychologists, clinical social workers, professional licensed counselors, and licensed marriage and family therapists
Payment for drugs for methadone treatment
Expanded access to audiology and dental/oral health services
Possible changes to “Skin Substitutes” in 2024
2024 CPT E/M Changes
Deleted Codes and Categories
Combined Categories
Home/Residence Services Changes
CMS General Prolonged Services Guidelines
AMA versus CMS Time Calculations for Prolonged Service
CMS Prolonged Service Confusion
CMS General Prolonged Services Guidelines
Hospital/Observation, Nursing Facility
Guidelines Controversy
Colorectal Cancer Screening
Telehealth
Chronic Pain Management
G0323 BHI
Behavioral Health Services
Opioid Treatments
Methadone Payment Policy
Opioid Treatment Programs
Additional Rules
Audiology Services
Dental & Oral Health Services
KX Modifier Thresholds
Discarded Drugs
RHC and FQHC
Revaluing Global Surgical Days
Live Q&A session

Who Should Attend

Healthcare Executives – CEOs, CFOs, COOs
Healthcare Providers
Billing Staff
Coding Staff
Office Managers
Auditors
Insurance payers
Coders
Accounts payable staff
Denial management staff
Payment policymakers
Denial resolution teams
Compliance officers
Clinic Managers
Physician and Non-physician Practitioners
Nurse Practitioners
Credentialing & Enrollment Staff
Insurance Company Claims Reviewers

All Days