Care management, behavioral health featured in final 2017 fee schedule

Why This Topic Matters

The rule affects multiple high-interest areas of Medicare payment and reporting, including care management, behavioral health, sedation, prolonged services, and practice enrollment requirements. Readers can use the article to determine whether the 2017 policy updates touch their specialty, workflow, or compliance responsibilities.

Article Sections

1. Overview of 2017 fee schedule changes

   Introduces the major service areas and policy updates highlighted in the final rule. Summarizes the broad scope of the Medicare physician fee schedule changes for 2017.

2. Care management and behavioral health codes

   Covers newly finalized care management and behavioral health-related services. Discusses the collaborative care model, complex chronic care management, and initiating visit-related updates.

3. Revisions to chronic care management billing rules

   Describes changes to Medicare billing requirements affecting care management services. Notes policy adjustments that alter how these services are administered and reported.

4. Conversion factors and payment updates

   Summarizes changes to Medicare and anesthesia conversion factors. Places the payment updates in the context of the final rule's broader reimbursement adjustments.

5. Global period data collection program

   Explains the scaled-back global period reporting initiative and the states and practices affected. Addresses the reporting framework and CMS implementation timeline at a high level.

6. Moderate sedation and related valuing changes

   Reviews the new moderate sedation code and the effect of RVU-related revisions. Also notes the article's discussion of procedure and anesthesia valuation issues.

7. Prolonged services and related limitations

   Covers CMS policy on separate payment for prolonged evaluation and management services. Includes general discussion of interactions with other service categories.

8. Medicare Diabetes Prevention Program

   Summarizes the finalized Medicare Diabetes Prevention Program model and participation requirements. Notes the program's implementation timing and general operational features.

9. Medicare Advantage enrollment and public data

   Describes enrollment requirements for providers and suppliers working with Medicare Advantage organizations. Also covers the public reporting of bid data and medical loss ratio data.

10. Fluoroscopy and Stark self-referral updates

    Discusses selected RVU and self-referral list revisions included in the final rule. Highlights the article's attention to imaging-related and physician self-referral policy changes.