Pay cuts for film X-rays, review of 0-day global period codes and more in proposed fee schedule

Why This Topic Matters

The proposed rule touches a wide range of Medicare Part B payment and reporting topics that can affect practice reimbursement, documentation workflows, telehealth operations, and compliance responsibilities. It also signals which services and policy areas CMS is scrutinizing for payment changes or reporting refinements in the coming year.

Article Sections

1. Billing and payments

   Overview of proposed payment updates and reductions affecting Medicare Part B services, imaging, and several provider payment methodologies. Also covers related geographic and malpractice pricing updates.

2. Compliance

   Broad compliance-related proposals, including open payments comments, rental arrangement policy, and Stark advisory opinion administration. Discusses CMS requests for input on reporting and oversight topics.

3. Telehealth

   Proposed changes to the telehealth list and billing requirements, including new service categories under consideration and reporting instructions for telehealth claims.

4. Misvalued codes

   CMS proposals related to code review, practice expense methodology, imaging equipment valuation, RVU phase-ins, and the agency’s misvalued code initiatives.

5. Policy changes

   Changes affecting quality reporting, overpayment handling, network billing issues, and the timeline for appropriate use criteria implementation for advanced imaging.

6. OPPS

   References related outpatient prospective payment system proposals that intersect with physician billing and hospital outpatient settings.