Part B Insider - 2021 Issue 10
CPT® 2022: Change Reporting Habits for Principal Care Management
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Article Overview
This article reviews principal care management (PCM) reporting changes associated with CPT 2022 and CMS’s Medicare Physician Fee Schedule proposal. It is aimed at coders, billers, and clinical documentation staff who need to understand how PCM is being addressed across CPT and Medicare payment policy, including the relationship to existing HCPCS Level II reporting and the planned transition discussed in the proposed rule.
Why This Topic Matters
PCM billing and payment guidance can affect how services are documented, reported, and reimbursed for Medicare beneficiaries and other patients. Readers need to know which code sets are involved, what type of policy changes are being discussed, and when those changes are expected to take effect.
Article Sections
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Understand PCM
Introduces principal care management and contrasts it with broader chronic care management concepts. The section frames the clinical and administrative context for the article’s coding discussion.
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In With The New Codes
Summarizes the CPT 2022 additions related to PCM and identifies the broad categories of service time they address. It also notes how the new reporting structure is organized at a high level.
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Know CMS’ Proposed Guidance
Reviews CMS’s proposed Medicare payment guidance for PCM and its relationship to prior Medicare reporting policy. The section also describes the policy direction discussed for Medicare beneficiaries and the associated code-set transition.
What You Will Learn
- How PCM fits within broader care management reporting
- Which code sets are affected by the 2022 PCM discussion
- How CMS’s proposed Medicare guidance relates to PCM reporting
- What general categories of service time the new and prior reporting structures address
- Why the article is relevant for Medicare payment policy planning
Who Should Read This
- Medical coders
- Billing professionals
- Physician practices
- Surgeons
- Clinical documentation staff
- Revenue cycle teams
Codes Discussed
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