Proposed physician fee schedule: CMS hopes eased reporting, new codes for care management will attract practices

Why This Topic Matters

The proposed changes could alter which care management services practices can report, how those services are structured, and which related services may be billed separately under Medicare. Practices that furnish care coordination services need to track these updates because they may affect reporting workflows, reimbursement, and service eligibility.

Article Sections

1. Proposed principal care management

   Discusses the proposed creation of a new care management service category for a single high-risk chronic condition. The section addresses the kinds of practitioners involved and the general relationship to broader care coordination services.

2. TCM the target of a pay raise

   Summarizes proposed changes affecting transitional care management under the Medicare fee schedule. It covers payment updates and the broader discussion of services CMS is considering for separate billing treatment.

3. Care plan comments solicited

   Describes CMS’s request for feedback on care plan language and outside coordination elements for care management services. The section focuses on proposed revisions to how comprehensive care plans are described.

4. ‘Substantial’ revision to complex CCM

   Covers proposed revisions to the requirements tied to complex chronic care management and related G-codes. It explains that CMS is considering new language for the care plan framework.

5. More CCM time for clinical staff

   Addresses proposed reporting changes for chronic care management time furnished by clinical staff. The section also notes CMS’s consideration of new code structure and timing thresholds.