decisionhealth Newsletters, Coder Pink Sheets - 2020 Issue 1 (January)
Final 2020 physician fee schedule: Care managed: CMS aims for changes that will close gaps in patient care
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Article Overview
This article explains CMS’s final 2020 Medicare physician fee schedule updates related to care management services. It is aimed at coders, billing staff, and clinicians who report chronic care, principal care, or transitional care management and want to understand the general areas of policy change, payment updates, and code-set development discussed by CMS and referenced industry commentary.
Why This Topic Matters
The article is relevant because it summarizes fee schedule changes that may affect how care management services are reported and reimbursed in 2020, including CMS’s direction on evolving code sets and concurrent billing topics.
Article Sections
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CMS changes affecting care management services
Overview of the final 2020 Medicare physician fee schedule changes affecting care management services and CMS’s rationale for revisiting the topic.
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Chronic care management and add-on services
Discussion of the chronic care management code set and related CMS updates, including the broader policy context around current and future revisions.
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Principal care management becomes effective
Introduction of principal care management and the general circumstances in which CMS expects this service category to be used.
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Transitional care management payment updates
Summary of payment changes and concurrent billing policy updates related to transitional care management services.
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Full descriptions for new care management services codes
Presentation of the new care management code descriptors and related explanatory material included with the article.
What You Will Learn
- Which care management service categories are addressed in the final 2020 fee schedule
- How CMS framed the policy changes affecting chronic, principal, and transitional care management
- What types of code-set changes and billing policy updates were discussed at a high level
- How the article organizes the new care management services information for 2020
Who Should Read This
- Medical coders
- Billing staff
- Practice managers
- Physicians and qualified health care professionals
- Specialists involved in care management
Codes Discussed
Code Ranges Discussed
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