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CMS Releases CY 2015 Physician Fee Schedule Rule

Posted on 7/7/2014 by NTOCC ® in Public Policy Updates

Last Thursday, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that would update payment policies and payment rates under the Medicare Physician Fee Schedule (PFS) for CY 2015. The proposed rule also proposes changes to several of the quality reporting initiatives for physicians including the Physician Quality Reporting System, Medicare Shared Savings Program, and Medicare Electronic Health Record Incentive Program, as well as changes to the Physician Compare tool on the website.

Of particular note for NTOCC members are changes to the chronic care management (CCM) codes, which were finalized in last year’s rule and set to go into effect beginning in 2015.  As you may recall last year, NTOCC submitted comments and strongly supported the proposed CCM codes which comprise a separate payment for non-face-to-face chronic care management services for Medicare patients with multiple chronic conditions who are at the highest risk of functional decline or death. 
Specifically, the rule proposes a payment rate of $41.92 for the CCM and proposes to allow greater flexibility in the supervision of clinical staff providing these services. Additionally, CMS details that they are forging proposing separate standards for practitioners furnishing these CCM services, which CMS had indicated they would create in last year’s rule.

CMS will accept comments on the proposed rule until September 2, 2014.  Please find attached two CMS fact sheets: NPRM Payment and NPRM Quality.  For the full proposed rule, please click here.

NTOCC staff will continue to examine the details of the proposed rule and will be discussing the development of comments with the Policy & Advocacy working group.