More 2021 PFS updates: Care management code changes, COVID billing rules and more

Why This Topic Matters

The updates touch multiple payment and reporting workflows across Medicare, Medicare Part D, and quality programs. Readers can quickly identify which areas of operations may need attention for the new calendar year and which CMS policies are being revised or extended.

Article Sections

1. Chronic care management code updated

   Introduces a change related to chronic care management billing under the 2021 Medicare physician fee schedule and notes the timing of the update.

2. Transitional care management expanded

   Summarizes expanded reporting options tied to transitional care management and related chronic care management activity.

3. eRx compliance delayed

   Covers a delay affecting electronic prescribing compliance timing for certain Medicare Part D prescriptions.

4. COVID-19 vaccines added to DHS exception list

   Explains a Stark law exception update involving COVID-19 vaccine-related services and designated health services policy.

5. COVID-19 specimen collection cliffhanger

   Discusses CMS coverage uncertainty for COVID-19 specimen collection services after the public health emergency ends.

6. Principal care management billing for rural health clinics and federally qualified health centers

   Describes principal care management policy changes affecting RHCs and FQHCs and how those services relate to existing care management billing structures.

7. CMS bundles PHE-supply code 99072

   Addresses CMS treatment of a public health emergency supply-related service and the broader billing context around bundled costs.

8. PHE-related supply pricing updates

   Summarizes interim pricing changes for selected supply inputs used during the public health emergency.

9. Price on scope video system nearly doubles in 2021

   Highlights updated pricing for scope equipment systems and related equipment categories used across many HCPCS services.

10. FQHC market basket

    Reviews the annual payment update methodology and rate change discussion for federally qualified health centers.

11. Medicaid Promoting Interoperability changes

    Covers finalized quality-measure and reporting changes for Medicaid Promoting Interoperability participants.

12. Shared Savings extreme and uncontrollable circumstances policy for quality reporting

    Summarizes how CMS is handling quality reporting accommodations for ACO participants affected by the public health emergency.

13. Multiple-source Part B drug reevaluation

    Discusses CMS policy considerations for pricing certain Part B drugs and the timing of the agency’s decision.

14. CURES Act changes to Certified EHR/Promoting Interoperability

    Covers technical and certification-related updates affecting certified EHR technology and related interoperability programs.