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Medicare and Compliance Changes*


On July 13th, The Centers for Medicare & Medicaid Services (CMS) released its proposed Medicare Physician Fee Schedule (PFS) rule for 2022. Attend this session to gain the facts and learn all you need to know to keep your practice on track and be in compliance on January 1.

The conversion factor will decrease again, but that is not the only negative factor on provider reimbursement for 2022. The past sequester and the PAYGO rule will also have an impact. Providers could be facing up to 9 percent in payment cuts next year unless Congress intervenes. Nearly all medical practices who bill Medicare should expect to feel the squeeze next year.

Get insight into the fate of telehealth services after the end of the public health emergency. What telephone codes will CMS continue to reimburse? They have retained Medicare Category 3 telehealth services, but how long will they pay for these services that appear on the list of temporary services? CMS intends for the home of a beneficiary to permanently qualify as an originating site and to lift geographic restrictions for mental health telehealth services, and even to allow the use of audio-only technology for certain mental telehealth services. What are the requirements for reimbursements for such services?

CMS plans to further delay penalties for the appropriate use criteria program for advanced diagnostic imaging services and to develop an accurate, stable payment rate for administration of preventative vaccines under Medicare Part B. For the QPP, CMS will transition to digital quality measurement and improve the collection of social determinants of health data. Expect additions to the MIPS eligible clinicians list for 2022, a delay to delay optional MVP reporting, and continuation of the complex patient bonus. Significant changes are proposed for shared services and critical care including the reporting requirements for code 99291.

Take a guided tour of these and other changes for 2022 that will directly impact provider reimbursement and/or healthcare compliance in the new year.

Highlights:

  • Direct payments to physician assistants
  • Critical care service billing (split/shared visits)
  • Time rules for therapy services provided by PT and OT assistants
  • Coverage for pulmonary rehab for COVID impacted patients
  • Changes to teaching physician rules and NCDs
  • RHC and FQHC mental health visits
  • OUD treatment - new add on code; medications and bundled services
  • Potential expansion to the types of providers whose Medicare enrollment can be denied or revoked
  • Physician Self-Referral and Open Payments Program updates
  • Clarification on the e-prescribing compliance date (Part D)
  • QPP- Details on changes to quality measures and threshold amounts
  • Surprise Billing Provisions in the Consolidated Appropriations Act (eff Jan 2022)
  • Recent additions to the OIG Workplan
  • OCR settlements & HIPAA Right of Access Initiative
  • OSHA emergency temporary standard

Full Schedule


Program times are Central unless otherwise noted.

SessionDate TimeInstructor
1December 15, 20212.00 pm - 5.00 pmShawntea Moheiser
Fee: $199.00Register

Can't attend a live session? Register anyway and you'll receive a link to the recording by the next business day.


CEUs:

PMI 3

Target audience: This is an intermediate-level course designed for medical office coders, billers, auditors, clinicians, and practice managers.