PBN’s 2022 predictions: PHE, NSA? Yes. Vaccines, telehealth? Not quite.

Why This Topic Matters

It helps readers understand which Medicare policy and payment issues were most active in 2022 and how CMS, Congress, and related stakeholders shaped the environment for physician practices and billing teams.

Article Sections

1. 2022 predictions

   An overview of the annual predictions review and the major policy and reimbursement themes examined in the article.

2. Prediction: The COVID public health emergency (PHE) will continue into 2023.

   Discussion of the public health emergency outlook and the broader policy environment affecting related practice changes.

3. Prediction: Facility-based split/shared policy will create coding errors, and CMS won’t offer additional guidance in the new year.

   Coverage of split/shared billing policy developments and CMS guidance timing in the physician and facility setting.

4. Prediction: Care management revenue will surpass $366 million in 2022.

   A review of care management utilization and revenue trends, including chronic care management and principal care management services.

5. Prediction: Insurers will start to penalize the unvaccinated.

   A brief look at vaccine-related coverage and premium concerns in the insurance market.

6. Prediction: Telehealth flexibilities will go permanent beyond behavioral health in 2022.

   Discussion of telehealth policy extensions, grace periods, and legislative action affecting post-PHE flexibility.

7. Prediction: Value-based models will be less episodic, more well-rounded.

   Summary of broader value-based care model activity at CMMI and related Medicare innovation efforts.

8. Prediction: Expect surprises from the No Surprises Act (NSA) — with good-faith estimates ambushing all practices.

   Coverage of No Surprises Act implementation, good faith estimate requirements, and CMS enforcement actions.