PFS news and notes: Final rule likely delayed, scope of practice loosened and much more

Why This Topic Matters

The proposed rule includes multiple changes that can affect how practices bill, document, and operationalize Medicare services in the coming year. Readers need a concise way to determine whether the full article contains updates relevant to their specialty, billing workflow, or compliance planning.

Article Sections

1. Timing of the 2021 final fee schedule

   Discusses expected release timing for the final Medicare physician fee schedule and the impact of the public health emergency on the rulemaking schedule.

2. Temporary PHE scope of practice extensions

   Summarizes proposed extensions related to practitioner roles, supervision, telehealth participation, and resident service flexibility during and after the public health emergency.

3. MDPP flexibilities maintained with changes

   Covers proposed updates to Medicare Diabetes Prevention Program flexibilities, participation rules, virtual services, and related beneficiary engagement considerations.

4. CMS debates axing COVID codes

   Addresses CMS review of specimen collection payment policies and whether temporary pandemic-related coding policies should remain after the public health emergency.

5. Nine outdated NCDs tagged for deletion

   Reviews proposed retirement of several national coverage determinations and the broader implications for Medicare coverage administration.

6. CMS refines medical device definition

   Explains CMS clarifications affecting remote physiologic monitoring device requirements and related reporting expectations.

7. Interactive communication for RPM treatment management explained

   Describes CMS guidance on the communication standard associated with remote physiologic monitoring treatment management services.

8. Two PHE changes made permanent

   Summarizes which pandemic-era remote monitoring-related changes CMS intends to keep and how those flexibilities would continue.

9. Transitional care management (TCM) revisions

   Covers proposed updates to concurrent billing restrictions and related care management policy changes involving transitional care management.

10. Principal care management billing for RHCs and FQHCs

    Discusses whether certain clinic types would be allowed to bill principal care management services separately under Medicare rules.

11. No standardized form for home infusion therapy

    Reviews proposed administrative policy on beneficiary notification for home infusion therapy options under the new Part B benefit.

12. Substance use disorder screening

    Covers proposed regulatory codification of screening questions for preventive visits and wellness visits under federal requirements.

13. Price on scopes goes way up

    Discusses a proposed market-based equipment price update affecting endoscopy-related supply and equipment valuation.

14. Note other market-based supply and equipment pricing updates

    Points readers to additional proposed pricing changes for supplies and equipment in the fee schedule tables.

15. Online exclusive: Additional news and notes

    Introduces additional proposed policy and pricing topics presented in the online-only portion of the article.

16. Find new venous stent system supply item

    Describes a proposed replacement supply item and related pricing update connected to venous stent procedures.

17. Naloxone added to opioid treatment

    Covers proposed opioid treatment program-related coverage additions and new reporting items tied to take-home opioid antagonists.

18. OTP enrollment allowed with institutional form

    Discusses proposed enrollment process changes for opioid treatment programs and associated administrative requirements.

19. New eCQMs for Medicaid PI’s last hurrah

    Lists proposed electronic clinical quality measures for the final year of the Promoting Interoperability Program.

20. FQHC market basket

    Explains the proposed update to the payment market basket used for federally qualified health centers.

21. Multiple-source Part B drug reevaluation

    Covers CMS proposals related to reassessment of how certain Part B drugs are classified and priced.

22. CMS invites comments on PT/INR monitoring values

    Addresses CMS requests for input on practice expense values and specialty crosswalk issues for home PT/INR monitoring services.

23. Newly priced equipment added to cardiac imaging codes

    Describes proposed equipment pricing and allocation updates for selected cardiac imaging services.

24. Just one spine device code proposed for 'potentially misvalued' revaluation

    Reviews a proposed valuation review for a spine-related code and the factors CMS says it will examine.

25. Codes for addiction drugs to be expanded

    Covers proposed expansion of drug billing codes for buprenorphine/naloxone products.

26. CMS delays eRx for Part D deadline

    Discusses a proposed extension of the deadline for electronic prescribing of controlled substances under Part D.