Proposed PFS round-up: More coding, billing, policy changes

Why This Topic Matters

These proposed changes can affect reimbursement, supervision arrangements, service coverage, and documentation workflows across multiple practice settings. Readers who bill Medicare or manage coding compliance need to know which policy areas may change and where implementation timelines or new billing structures may apply.

Article Sections

1. Split/shared billing and telehealth payment policies

   Covers proposed Medicare payment and supervision updates affecting split/shared services, telehealth place-of-service treatment, and related virtual care flexibilities.

2. Telephone services and electronic prescribing enforcement

   Summarizes proposed policy stability for telephone evaluation services and Medicare’s approach to electronic prescribing compliance actions.

3. Remote therapeutic monitoring and therapy threshold changes

   Discusses supervision proposals for remote therapeutic monitoring and annual therapy threshold updates involving modifier-based billing concerns.

4. Diabetes screening, medical nutrition therapy, and DSMT

   Reviews proposed changes to diabetes screening coverage, testing frequency, and related updates for medical nutrition therapy and diabetes self-management training.

5. Skin substitute pricing and billing methodology

   Addresses CMS requests for comment on pricing sources, billing structure, and possible coding approaches for wound-related products.

6. Pulmonary, cardiac, and intensive cardiac rehabilitation supervision

   Summarizes the proposed expansion of eligible clinicians who may supervise rehabilitation programs and the related coverage setting issues.

7. Hospice interdisciplinary care team updates

   Covers proposed hospice participation changes involving behavioral health professionals and team composition.

8. Geographic practice cost indices and locality adjustments

   Explains proposed updates to geographic payment adjustment data and related technical locality changes for selected areas.

9. Diabetes self-management training and medical nutrition therapy billing

   Expands on proposed operational and billing clarifications for DSMT and MNT services, including telehealth-related flexibilities.

10. Dental services connected to covered medical care

    Reviews proposed coverage policy for certain dental services linked to broader medical treatment and requests for additional stakeholder input.

11. Rural health clinics and federally qualified health centers

    Covers proposed billing, supervision, telehealth, chronic care, and remote service changes for RHCs and FQHCs, plus new community-based care codes.