CMS eases G2211 and -25, floats Part B drug rebate changes, more

Why This Topic Matters

These proposed changes could alter how common Medicare services are reported, paid, or classified in multiple care settings. Readers who bill Medicare services need to understand which policies are changing, which codes are being retired or replaced, and where CMS is seeking to align payment across provider types.

Article Sections

1. Fee schedule round-up

   Overview of proposed Medicare physician fee schedule updates and related billing and coding topics introduced by CMS.

2. More opportunities to report the office/other outpatient complexity add-on code

   Discusses proposed changes affecting reporting of a complexity add-on service in relation to preventive and wellness encounters.

3. Medicare Prescription Drug Inflation Rebate Program

   Summarizes proposed administrative and technical refinements related to the Part B and Part D rebate framework under the Inflation Reduction Act.

4. CMS plans to adopt brief virtual visit code, skip telehealth codes

   Covers proposed changes to virtual communication services and the treatment of newly created telehealth-related coding in Medicare.

5. Medicare Diabetes Prevention Program (MDPP)

   Reviews proposed updates to MDPP delivery formats, participant reporting options, and related billing requirements.

6. Proposals on Medicare Parts A and B payment for dental services

   Addresses proposed Medicare dental payment policies, including eligibility tied to certain covered clinical situations and other conditions considered by CMS.

7. Rural health clinics (RHC) and federally qualified health centers (FQHC) policy updates

   Summarizes proposed technical and payment changes for rural health clinics and federally qualified health centers, including telehealth, care management, and preventive service billing.